Zoll Propaq M User manual

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Propaq® M Operator’s Guide

REF: 9650-000820-01 Rev. K SW VER: 02.30.01.00

0123

ZOLL Medical Corporation

269 Mill Road Chelmsford, MA USA 01824-4105

ZOLL International Holding B.V.

Newtonweg 18 6662 PV ELST The Netherlands

The issue date for the Propaq M Operator's Guide (

REF 9650-000820-01 Rev. K) is November, 2016.

Copyright © 2016 ZOLL Medical Corporation. All rights reserved. RescueNet, SurePower, and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries. All other trademarks are the property of their respective owners.

Masimo, Rainbow, SET, SpCO, SpMet, SpHb, SpOC, and PVI are trademarks or registered trademarks of Masimo Corporation in the United States and/or other countries.

Propaq is a registered trademark of Welch Allyn Inc.

Oridion Microstream FilterLine

and Smart CapnoLine® are registered trademarks of Medtronic plc.

Table of Contents

Chapter 1 General Information

Product Description ............................................................................................................ 1-1

Propaq M Optional Features ....................................................................................... 1-2

How to Use This Manual..................................................................................................... 1-2

Operator’s Guide Updates .................................................................................................. 1-2

Unpacking...........................................................................................................................1-2

Symbols Used on the Equipment ....................................................................................... 1-3

Conventions........................................................................................................................ 1-6

Propaq M Indications for Use..............................................................................................1-6

ECG Monitoring .......................................................................................................... 1-6

Non-Invasive Blood Pressure Monitoring ................................................................... 1-6

Temperature Monitoring ............................................................................................. 1-7

SpO2 Monitoring ......................................................................................................... 1-7

Respiration Monitoring ................................................................................................ 1-7

CO2 Monitoring ........................................................................................................... 1-7

Invasive Pressure Monitoring ..................................................................................... 1-7

12-Lead Analysis ........................................................................................................ 1-7

Propaq M Product Functions .............................................................................................. 1-8

ECG Monitoring .......................................................................................................... 1-8

Batteries ......................................................................................................................1-8

Ready For Use (RFU) Indicator .................................................................................. 1-9

Warnings........................................................................................................................... 1-10

General .....................................................................................................................1-10

ECG Monitoring ........................................................................................................ 1-11

Pulse Oximeter ......................................................................................................... 1-11

Noninvasive Blood Pressure ..................................................................................... 1-12

IBP ............................................................................................................................1-12

CO2 ..........................................................................................................................1-12

Respiration ................................................................................................................1-13

Ferromagnetic Equipment ........................................................................................ 1-13

Battery ...................................................................................................................... 1-13

Operator Safety ........................................................................................................ 1-13

Patient Safety ........................................................................................................... 1-14

Cautions............................................................................................................................ 1-14

Restarting the Monitor....................................................................................................... 1-15

Notification of Adverse Events .................................................................................. 1-15

Software License .............................................................................................................. 1-16

Service..............................................................................................................................1-16

The ZOLL Serial Number.................................................................................................. 1-18

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Table of Contents

Chapter 2 Product Overview

Propaq M Controls and Indicators ..................................................................................... 2-2

Propaq M with Printer (Optional) Control and Indicators .................................................... 2-3

The Front Panel .................................................................................................................. 2-4

Display Screen ............................................................................................................ 2-6

Battery Status and Auxiliary Power Indicators ............................................................ 2-7

Patient Cables and Connectors .......................................................................................... 2-8

Auxiliary Power Adapter ..................................................................................................... 2-9

Navigating the Display Screen.......................................................................................... 2-10

Quick Access Keys ................................................................................................... 2-10

Navigation Keys ....................................................................................................... 2-12

Display Brightness Modes ........................................................................................ 2-13

Common Tasks ................................................................................................................. 2-13

Setting the Date and Time ........................................................................................ 2-13

Changing the Display Brightness .............................................................................. 2-14

Replacing a Battery Pack on the Propaq M Unit (No Printer) ................................... 2-15

Replacing a Battery Pack on the Propaq M Unit with Printer ................................... 2-16

Using Treatment Buttons .......................................................................................... 2-17

Chapter 3 Monitoring Overview

Propaq M Monitoring Functions.......................................................................................... 3-1

ECG ............................................................................................................................3-2

Heart Rate .................................................................................................................. 3-2

Respiration Rate ......................................................................................................... 3-2

Temperature ...............................................................................................................3-2

Invasive Pressures (IBP) ............................................................................................ 3-2

Non-Invasive Blood Pressure (NIBP) ......................................................................... 3-2

Capnography (CO2) ................................................................................................... 3-3

Pulse Oximetry (SpO2) ............................................................................................... 3-3

Monitoring Display Options................................................................................................. 3-4

Configuring the Waveform Display ..................................................................................... 3-6

Chapter 4 Trends

Displaying the Trends Status Window ................................................................................ 4-2

Printing Trend Information .................................................................................................. 4-3

Printing Trend Summary ............................................................................................. 4-3

Printing an Individual Trend Snapshot ........................................................................ 4-3

Printing The 10 Most Recent Trend Snapshots .......................................................... 4-3

Printing Specific Trend Snapshots .............................................................................. 4-3

Changing the Trends Status Window Display..................................................................... 4-3

Continuous Waveform Recording ............................................................................... 4-4

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Chapter 5 Alarms

Visual Alarm Indicators ....................................................................................................... 5-2

Audible Alarm Indicators..................................................................................................... 5-2

Alarm Indicator Self-Test..................................................................................................... 5-2

Patient Alarm Display ......................................................................................................... 5-3

Life Threatening Rhythm Alarms ........................................................................................ 5-4

Equipment Alert Display ..................................................................................................... 5-4

Responding to Active Alarms -- Silencing the Alarm .......................................................... 5-5

Re-enabling an Alarm ................................................................................................. 5-5

Latching Alarms .......................................................................................................... 5-5

Pausing (Suspending) Alarms ............................................................................................ 5-6

Alarm Reminders ........................................................................................................ 5-7

Alarm Options ..................................................................................................................... 5-7

Selecting Default Alarm Limits .................................................................................... 5-8

Setting Alarm Limits Relative to the Patient -- Stat Set Option ................................... 5-8

Chapter 6 Monitoring ECG

ECG Monitoring Setup........................................................................................................ 6-3

Preparing the Patient for Electrode Application .......................................................... 6-3

Applying Electrodes to the Patient .............................................................................. 6-4

Connecting the ECG Cable To the Propaq M Unit ..................................................... 6-6

Selecting ECG Waveforms for Display ....................................................................... 6-6

Selecting the Waveform Trace Size ........................................................................... 6-8

ECG Monitoring and Pacemakers ...................................................................................... 6-9

ECG System Messages...................................................................................................... 6-9

Chapter 7 Monitoring Respiration (Resp) and Heart Rate (HR)

Respiration/Breath Rate Meter ........................................................................................... 7-2

Using Impedance Pneumography to Measure Respiration ........................................ 7-2

Configuring Respiration (RR/BR) Alarms and Settings ......................................................7-3

Enabling/Disabling RR/BR Alarms and Setting Alarm Limits ...................................... 7-3

Using the Resp Parameter Control Panel ................................................................... 7-4

Heart Rate Meter ................................................................................................................7-5

Configuring Heart Rate (HR) Meter Alarms ........................................................................ 7-5

Enabling/Disabling HR Alarms and Setting Alarm Limits ............................................ 7-5

Life Threatening Rhythm Alarms ................................................................................ 7-6

Using the Heart Rate Parameter Control Panel .......................................................... 7-8

RESP System Message ..................................................................................................... 7-8

Chapter 8 Monitoring Non-Invasive Blood Pressure (NIBP)

How does NIBP Work? ....................................................................................................... 8-3

The NIBP Numeric Display .................................................................................................8-4

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NIBP Setup and Use........................................................................................................... 8-4

Selecting the NIBP Cuff ...................................................................................................... 8-5

Connecting the NIBP Cuff................................................................................................... 8-6

Applying the Cuff to the Patient .......................................................................................... 8-8

Ensuring Correct Cuff Inflation Settings............................................................................ 8-10

Configuring NIBP Alarms and Settings............................................................................. 8-11

Enabling/Disabling NIBP Alarms and Setting Alarm Limits ...................................... 8-11

Using the NIBP Parameter Control Panel ................................................................. 8-13

NIBP System Messages ...................................................................................................8-16

Chapter 9 Monitoring CO2

Overview.............................................................................................................................9-1

CO2 Monitoring Setup and Use.......................................................................................... 9-2

Selecting the CO2 Sampling Line ............................................................................... 9-3

Connecting the CO2 Sampling Lines .......................................................................... 9-4

Applying a FilterLine Set ............................................................................................. 9-5

Applying a Smart CapnoLine Nasal or Nasal/Oral Cannula ....................................... 9-6

Measuring CO2...................................................................................................................9-7

Setting CO2 and Respiration Rate Alarms ......................................................................... 9-8

Enabling/Disabling Alarms and Setting CO2 Alarm Limits ......................................... 9-8

Using the CO2 Parameter Control Panel .................................................................. 9-10

System Messages ............................................................................................................ 9-11

Patents.............................................................................................................................. 9-12

Chapter 10 Pulse CO-Oximetry (SpO2)

Warnings -- SpO2 General................................................................................................ 10-3

Cautions............................................................................................................................ 10-5

SpO2 Setup and Use........................................................................................................ 10-6

Selecting the SpO2 Sensor............................................................................................... 10-6

Applying the SpO2 Sensor................................................................................................ 10-6

Applying a Two-Piece Single-Use Sensor/Cable ...................................................... 10-7

Applying a Reusable Sensor/Cable .......................................................................... 10-9

Cleaning and Reuse of Sensors ............................................................................... 10-9

Connecting the SpO2 Sensor ......................................................................................... 10-10

Displaying Measurements............................................................................................... 10-10

Enabling/Disabling SpO2 Alarms and Setting Alarm Limits............................................ 10-11

Setting Upper and Lower SpO2 Alarm Limits ......................................................... 10-11

Setting Upper and Lower SpCO and SpMet Alarm Limits ......................................10-12

Setting Upper and Lower SpHb Alarm Limits ......................................................... 10-12

Setting Upper and Lower SpOC Alarm Limits ........................................................ 10-13

Setting Upper and Lower PVI Alarm Limits ............................................................ 10-13

Setting Upper and Lower PI Alarm Limits ............................................................... 10-13

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Using the SpO2 Parameter Control Panel ...................................................................... 10-14

SpCO and SpMet, and SpHb, SpOC, PVI and PI Monitoring ................................. 10-14

Specifying the SpO2 Averaging Time ..................................................................... 10-14

Selecting the SpO2 Sensitivity ................................................................................ 10-14

Selecting SpHb Venous Mode ................................................................................ 10-15

Specifying the SpHb Averaging Time ..................................................................... 10-15

Selecting the Heart Rate/ Pulse Rate (HR/PR) Tone ............................................. 10-15

SpO2 System Messages ................................................................................................ 10-15

Functional Testers and Patient Simulators ..................................................................... 10-16

Patents............................................................................................................................ 10-16

Chapter 11 Monitoring Invasive Pressures (IBP)

Invasive Pressure Transducers ........................................................................................ 11-1

IBP Setup.......................................................................................................................... 11-2

Attaching the Invasive Pressure Transducer .................................................................... 11-3

Zeroing the Transducer..................................................................................................... 11-4

Rezeroing a Transducer ................................................................................................... 11-5

Displaying IBP Measurements.......................................................................................... 11-5

Conditions Affecting IBP Measurements .................................................................. 11-5

Enabling/Disabling IBP Alarms and Setting Alarm Limits ................................................. 11-6

Setting Upper and Lower Systolic (SYS) Alarm Limits ............................................. 11-6

Setting Upper and Lower Diastolic (DIA) Alarm Limits ............................................. 11-7

Setting Upper and Lower Mean Arterial Pressure (MEAN) Alarm Limits .................. 11-7

Setting IBP Source Label .......................................................................................... 11-8

IBP System Messages...................................................................................................... 11-9

Chapter 12 Monitoring Temperature

Temperature Monitoring Setup ......................................................................................... 12-2

Selecting and Applying Temperature Probes.................................................................... 12-2

Connecting the Temperature Probe ..................................................................................12-2

Displaying Temperature .................................................................................................... 12-3

Enabling/Disabling Temperature Alarms and Setting Alarm Limits................................... 12-3

Setting Upper and Lower Temperature Alarm Limits ........................................................ 12-3

Setting Upper and Lower Temperature Alarm Limits ....................................................... 12-4

Selecting the Temperature Label ...................................................................................... 12-4

Temperature System Messages .......................................................................................12-5

Chapter 13 12-Lead ECG Interpretive Analysis

Entering Patient Information ............................................................................................. 13-3

Entering the Patient Name and ID ............................................................................ 13-3

Entering Patient Age and Gender ............................................................................. 13-4

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12-Lead ECG Monitoring Setup........................................................................................ 13-4

Preparing the Patient for Electrode Application ........................................................ 13-5

Applying Electrodes to the Patient ............................................................................ 13-5

Connecting the 12-Lead Cable ................................................................................. 13-7

Observing the 12-Lead Waveform Traces ................................................................ 13-7

12-Lead Interpretive Analysis ................................................................................... 13-8

Fault Conditions Affecting 12-Lead Interpretive Analysis ....................................... 13-11

Printing 12-Lead Waveform Traces ................................................................................ 13-12

12-Lead Print and Display Options ................................................................................. 13-13

Selecting 12-Lead Acquire ...................................................................................... 13-13

Specifying the Number of 12-Lead Print Copies ..................................................... 13-13

Specifying the 12-Lead Print Format ...................................................................... 13-14

Printing 10 Seconds of Waveform Traces .............................................................. 13-16

Specifying the 12-Lead Frequency Response ........................................................ 13-16

Enabling 12-Lead Analysis ..................................................................................... 13-16

Enabling Interpretive Text ....................................................................................... 13-16

Chapter 14 Patient Data

Storing Data ...................................................................................................................... 14-1

Log Capacity Indicator .............................................................................................. 14-2

Capturing a Data Snapshot............................................................................................... 14-2

Reviewing Snapshots ............................................................................................... 14-2

Printing Snapshots (Optional) ................................................................................... 14-2

Treatment Summary Report ............................................................................................. 14-3

Transferring Data to a USB Device...................................................................................14-3

Chapter 15 Communications

The Wireless Icon ............................................................................................................. 15-2

The Wireless Menu........................................................................................................... 15-4

Selecting a Pre-Configured Access Point Profile ...................................................... 15-5

Creating a Temporary Access Point Profile .............................................................. 15-6

Bluetooth Device Pairing ........................................................................................ 15-10

Sending a 12-Lead Report.............................................................................................. 15-12

Sending Disclosure Logs ................................................................................................ 15-13

Supervisor Communications Menu................................................................................. 15-14

Overview .................................................................................................................15-14

Accessing the Communications Menu .................................................................... 15-14

Wi-Fi Access Point Profiles ..................................................................................... 15-16

Setting up Cellular Communications ....................................................................... 15-23

Setting up an Ethernet Connection ......................................................................... 15-28

Configuring 12-Lead Report Transmissions ........................................................... 15-29

Configuring Disclosure Log Transmissions ............................................................ 15-31

Data Services ......................................................................................................... 15-33

Configuring Clock Synchronization .........................................................................15-35

Communications System Messages............................................................................... 15-37

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Transmission Status Icons .............................................................................................. 15-38

Chapter 16 Printing

Printing Patient Data......................................................................................................... 16-1

Printer Setup ............................................................................................................. 16-2

Automatic Prints ........................................................................................................ 16-2

Printing Waveforms .................................................................................................. 16-3

Printing Reports ........................................................................................................ 16-3

Printing Trends ......................................................................................................... 16-4

Chapter 17 Cleaning and Maintenance

Inspection and Cleaning instructions ................................................................................ 17-1

Cleaning the Propaq M unit ...................................................................................... 17-2

Cleaning the NIBP Blood Pressure Cuff ................................................................... 17-2

Cleaning SpO2 Sensors ........................................................................................... 17-2

Cleaning Cables and Accessories ............................................................................ 17-3

Loading Recorder Paper ........................................................................................... 17-3

Cleaning the Print Head ............................................................................................ 17-4

Recommended Minimum Preventive Maintenance Schedule .......................................... 17-5

Guidelines for Maintaining Peak Battery Performance ..................................................... 17-6

Appendix A Specifications

Monitor/Display ...................................................................................................................A-2

Impedance Pneumography.................................................................................................A-3

Alarms.................................................................................................................................A-4

Printer (Recorder) ...............................................................................................................A-5

Battery ................................................................................................................................A-5

General ...............................................................................................................................A-6

CO2 ....................................................................................................................................A-7

Pulse Oximeter ...................................................................................................................A-8

Non-Invasive Blood Pressure ........................................................................................... A-11

Invasive Pressures ...........................................................................................................A-12

Temperature......................................................................................................................A-13

Electromagnetic Compatibility Guidance and Manufacturer’s Declaration .......................A-14

Wireless Output Guidance and Manufacturer’s Declaration.............................................A-18

RF Transmission Emitted (IEC 60601-1-2) ...............................................................A-18

FCC Notice ...............................................................................................................A-18

Canada, Industry Canada (IC) Notices .....................................................................A-18

Appendix B Accessories

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Product Description

The ZOLL® Propaq® M unit is an easy-to-use portable monitor that has the following monitoring capabilities: ECG, CO-Oximeter, Non-invasive Blood Pressure, IBP, CO

Temperature, and Respiration. It has been designed for all resuscitation situations and its rugged, compact, lightweight design makes it ideal for transport situations. It is powered by auxiliary power and an easily replaced battery pack that is quickly recharged in the device when it is connected to auxiliary power. In addition, the unit’s battery may be recharged and tested using a ZOLL SurePower™ Battery Charger Station.

Note: Some of the monitoring functions are optional features. See the complete list of

options in Fig. Note:. All features are included in this manual, but only purchased features will be available on your unit.

The product is designed for use in hospital, EMS, and rugged military environments. The unit has a large colorful LCD display of numerics and waveform data that provides easy visibility from across the room and at any angle. ECG, plethysmograph, and respiration waveform traces can be displayed simultaneously, giving easy access to all patient monitoring data at once. The display screen is configurable, so you can choose the best visual layout to fit your monitoring needs.

Chapter 1

General Information

The Propaq M has a patient data review and collection system that allows you to view, store, and transfer patient data. The Propaq M unit contains a USB port, which you can use to transfer data to a PC and, optionally, a printer, that you can use to print patient data.

The Propaq M unit can send data through a wireless connection to remote locations. The unit can send 12-lead report snapshots (including trend data) or disclosure logs to a recipient via a ZOLL server. In addition, full disclosure cases, which also contain trend data, can be automatically retrieved from the Propaq M unit using ZOLL RescueNet

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or ePCR software.

Chapter 1 General Information

Propaq M Optional Features

The following features are optional in the Propaq M unit.

Note: All features are included in this manual, but only purchased features will be available

on your unit.

Optional Feature

12-Lead ECG with Interpretation

SpO2 (Masimo®) with SpCO® and SpMet

SpHb® (Masimo®) with SpOCTM, PVI® and PI

NIBP (with Smartcuf

EtCO

(Oridion® Microstream®)

Temperature (2 Channels)

Invasive Pressures (3 Channels)

Printer

and SureBPTM)

How to Use This Manual

The Propaq M Operator's Guide provides information operators need for the safe and effective use and care of the Propaq M product. It is important that all persons using this device read and understand all the information contained within.

Please thoroughly read the safety considerations and warnings section.

Procedures for daily checkout and unit care are located in the Chapter 17, "Cleaning and Maintenance".

Operator’s Guide Updates

An issue or revision date for this manual is shown on the front cover. If more than three years have elapsed since this date, contact ZOLL Medical Corporation to determine if additional product information updates are available.

All users should carefully review each manual update to understand its significance and then file it in its appropriate section within this manual for subsequent reference.

Product documentation is available through the ZOLL website at www.zoll.com. From the Products menu, choose Product Manuals.

Unpacking

Carefully inspect each container for damage. If the shipping container or cushion material is damaged, keep it until the contents have been checked for completeness and the instrument has been checked for mechanical and electrical integrity. If the contents are incomplete, if there is mechanical damage, or if the monitor does not pass its electrical self-test, U.S.A. customers should call ZOLL Medical Corporation (1-800-348-9011). Customers outside of the U.S.A. should contact the nearest ZOLL authorized representative. If the shipping container is damaged, also notify the carrier.

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Symbols Used on the Equipment

Any or all of the following symbols may be used in this manual or on this equipment:

Symbol Description

Attention, consult accompanying documents.

Fragile, handle with care.

Keep dry.

This end up.

Temperature limitation.

Symbols Used on the Equipment

Conformité Européenne Complies with medical device directive 93/42/EEC.

Type CF patient connection.

Fusible link.

Alternating current (ac).

Direct current (dc).

Auxiliary power adapter operation.

Earth (ground).

Negative input terminal.

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Chapter 1 General Information

2%452.

,I)/.

RECYCLE

,I)/.

Symbol Description

Positive input terminal.

Power On/Off

Protective earth (ground).

Contains lithium. Recycle or dispose of properly.

Keep away from open flame and high heat.

Do not open, disassemble, or intentionally damage.

Do not crush.

Do not discard in trash. Recycle or dispose of properly.

Return to a collection site intended for waste electrical and electronic equipment (WEEE). Do not dispose of in unsorted trash.

Date of manufacture.

Use by.

Latex-free.

Do not reuse.

Do not fold.

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Symbol Description

Not sterile.

Manufacturer.

Authorized representative in the European Community.

Serial Number.

Catalogue number.

Consult instructions for use.

Symbols Used on the Equipment

Refer to instruction manual/booklet.

Prescription only.

Alarm audio is currently off.

Alarm audio is currently paused.

Pacer indicator disabled.

Battery charging status.

Do not use device, cables, or probes in an MRI environment.

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Chapter 1 General Information

Conventions

This guide uses the following conventions:

Within text, the names and labels for physical buttons and softkeys appear in boldface type (for example, “Press the IBP quick access key”).

This guide uses uppercase italics for audible prompts and for text messages displayed on the screen (for example, INITIALIZING).

Warning! Warning statements alert you to conditions or actions that can result in personal injury

or death.

Caution Caution statements alert you to conditions or actions that can result in damage to the unit.

Propaq M Indications for Use

The Propaq M is intended for use by trained medical personnel who are familiar with basic monitoring, vital sign assessment, and the use of the Propaq M. The Propaq M is also intended for use by (or on the order of) physicians at the scene of an emergency or in a hospital emergency room, intensive care unit, cardiac care unit, or other similar areas of a hospital. The usage may be in an ambulance or at the scene of an emergency. It is also intended to be used during the transport of patients. The Propaq M will be used whenever it is required to monitor any of those functions that are included (as options) in the device. The Propaq M unit can be used on pediatric patients (as described in the following table) and on adult patients (21 years of age or older) with and without heart dysfunction.

Pediatric Patient Subpopulation Approximate Age Range

Newborn (neonate) Birth to 1 month of age.

Infant 1 month to 2 years of age.

Child 2 to 12 years of age.

Adolescent 12 to 21 years of age.

ECG Monitoring

The Propaq M is intended for use to monitor and/or record 3-, 5-, or 12-lead ECG waveform and heart rate, and to alarm when heart rate is above or below limits set by the operator. The patient population will range from newborn (neonate) to adult, with and without heart dysfunction.

Non-Invasive Blood Pressure Monitoring

The Propaq M unit’s NIBP option is intended for use to make non-invasive measurements of arterial pressure and heart rate, and to alarm if either parameter is outside of the limits set by the user. Measurements are made using an inflatable cuff on the patient's arm or leg. The patient population will range from newborn (neonate) to adult.

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Temperature Monitoring

The Propaq M is intended for use to make continuous temperature measurements of rectal, esophageal, or surface temperatures, and to alarm if the temperature is outside of the limits set by the user. The patient population will range from newborn (neonate) to adult.

SpO2 Monitoring

The Propaq M pulse CO-oximeter, with Masimo Rainbow® SET® technology, is intended for use for continuous noninvasive monitoring of functional oxygen saturation of arterial hemoglobin (SpO

saturation (SpMet), total hemoglobin (SpHb), oxygen content (SpOC), pleth variability index (PVI), and/or perfusion index (PI). The pulse CO-oximeter and accessories are indicated for use on adult, pediatric, and neonatal patients during both no motion and motion conditions, and for patients who are well or poorly perfused, in hospitals, hospital-type facilities, or in mobile environments.

Respiration Monitoring

The Propaq M is intended for use to continuously monitor respiration rate and to alarm if the rate falls outside of the range set by the operator. Because the measurement method actually measures respiratory effort, apnea episodes with continued respiratory effort (such as obstructive apnea) may not be detected. It is not intended to be used as an apnea monitor. The patient population will range from newborn (neonate) to adult.

Propaq M Indications for Use

), pulse rate, carboxyhemoglobin saturation (SpCO), and/or methemoglobin

CO2 Monitoring

The Propaq M is intended for use to make continuous noninvasive measurement and monitoring of carbon dioxide concentration of the expired and inspired breath and breath rate. The patient population will range from newborn (neonate) to adult.

Invasive Pressure Monitoring

The Propaq M is intended for use to display and make continuous invasive pressure measurements from any compatible pressure transducer. The primary intended uses are arterial blood pressure, central venous pressure and intracranial pressure monitoring. Any contraindications of the particular transducer selected by the user shall apply. The patient population will range from newborn (neonate) to adult.

12-Lead Analysis

The 12-lead ECG Analysis is intended for use in acquiring, analyzing and reporting ECG data, and to provide interpretation of the data for consideration by caregivers. The interpretations of ECG data offered by the device are only significant when used in conjunction with caregiver overread as well as consideration of all other relevant patient data. The 12-lead ECG Analysis is intended for use on adults (> 18 years of age).

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Chapter 1 General Information

Propaq M Product Functions

ECG Monitoring

The patient’s ECG is monitored by connecting the patient to the unit via a 3-, 5-, or 12-lead patient cable. The ECG waveform is presented on the display along with the following information:

• averaged heart rate, derived by measuring R to R intervals

• lead selection - I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6 (with ECG cable).

• ECG size - 0.125, 0.25, 0.50, 1.0, 2.0, 4.0 cm/mV, AUTO

• status messages

The ECG bandwidth is user selectable.

Batteries

Propaq M models use an easily replaced rechargeable lithium-ion battery pack (the SurePower II Battery Pack). A new, fully charged battery pack typically delivers more than 8 hours of ECG

monitoring. Use of other functions (such as higher screen brightness or shorter NIBP intervals) reduces this time.

When a LOW BATTERY icon appears on the display and the unit emits three beeps in conjunction with the displayed battery icon, the battery must be replaced and recharged.

You can charge the battery by either of the following methods:

• Internal charging — plug the Propaq M into an auxiliary power adapter to automatically

begin charging the installed battery pack. The front panel battery indicator operates as follows:

When the indicator is: It means:

Steady yellow Battery is charging.

Steady green Battery is charged.

Alternating yellow and green

Not lit No battery in device.

The charge state cannot be determined or a battery charging fault has been detected.

Note: Upon power up, it takes approximately 45 seconds for the LEDs on the battery to

accurately display run time.

• External charging — use the ZOLL SurePower Battery Charger with the Propaq M/MD

Charger Adaptor to charge the battery pack and test the battery’s capacity. For details, refer to the SurePower II Battery Pack Guide.

The Recalibration LED icon ( ) lights for approximately 10 seconds (after you press and release the Display button) if the battery needs to be calibrated. If the Recalibration LED lights, the runtime indicator will not display run time for that battery. For best performance of the battery, you should recalibrate the battery as soon as possible.

To manually recalibrate the SurePower II Battery Pack, you can insert the battery into the SurePower Charger Station and perform a Manual Test (for more information, see the ZOLL SurePower Charger Station Operator’s Guide).

After you recalibrate the battery, the Recalibration LED will only flash when you press the Display button.

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Ready For Use (RFU) Indicator

The Propaq M has an RFU indicator on the front panel that indicates if the device is ready for use. The RFU indicator has three states which are described in the following table.

State Description Action

Propaq M Product Functions

Ready for Use The device is ready for use. Patient

monitoring is functional and the battery is above the low battery capacity.

Note: If the device is plugged into the auxiliary power adapter, the Ready for Use indicator may display even if the battery is depleted. Check the status of the battery before removing the device from the auxiliary power adapter.

Flashing One or more of the following has

occurred:

• The battery is not properly installed.

• A low battery is installed.

• A battery fault has occurred.

• There is no battery installed

while connected to auxiliary power.

• One or more patient monitoring parameters have failed self-test (NIBP, SpO

Temp).

• The front panel button self-test failed.

• The speech database self-test failed.

, CO2, IBP, or

None required.

Install a fully charged battery in the unit and check the RFU indicator again. If the RFU indicator continues to flash, remove the unit from service and contact the appropriate technical personnel or the ZOLL Technical Service Department.

Do Not Use One or more of the following has

occurred:

• The battery is not properly installed.

• No battery is installed and auxiliary power is not present.

• A very low battery (below software shutdown limit) was installed.

• ECG self-tests have failed, or other critical self-tests have failed.

Install a fully charged battery in the unit and check the RFU indicator again. If the RFU indicator continues to display the Do Not Use symbol, remove the unit from service and contact the appropriate technical personnel or the ZOLL Technical Service Department.

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Chapter 1 General Information

Warnings

General

• These operating instructions describe the functions and proper operation of the Propaq M

products. They are not a substitute for a formal patient care training course. Operators should obtain formal training from an appropriate authority before using this monitor for patient care.

• Proper operation of the unit and correct electrode placement is critical to obtaining optimal

results. Operators must be thoroughly familiar with proper device operation.

• Allow ample slack in cables to make sure that cables do not tug at electrodes.

• Do not disassemble the unit. A shock hazard exists. Refer all problems to authorized service

personnel.

• Follow all recommended maintenance instructions. If a problem occurs, obtain service

immediately. Do not use the monitor until it has been inspected by appropriate personnel.

• The Propaq M unit might not perform to specifications when stored at the upper or lower

extreme limits of storage temperature and then immediately put into use. The Propaq M unit should not be stored or used outside of the environmental limits provided in Appendix A of this manual.

• Avoid using the Propaq M adjacent to, or stacked on, other equipment. If unavoidable,

verify that the unit operates normally in this configuration before clinical use.

• The Propaq M unit should be installed and put into service according to the EMC

information in Appendix A of this manual.

• The use of transducers and cables other than those specified in this manual and related

Propaq M option manual inserts may result in increased emissions or decreased immunity of the Propaq M.

• Do not use or place the unit in service if the Ready For Use indicator (at the upper right of

the front panel) displays a red circle with a line through it.

• Carefully route patient cables to avoid tripping over them, or inadvertently pulling the unit

onto the patient.

• Always inspect the unit for damage if it has been dropped.

• Only authorized personnel should use the Supervisor menus.

• If uncertain about the accuracy of any measurement, first check the patient’s vital signs by

alternate means, and then make sure the monitor is functioning correctly.

• Before disposing equipment, in order to avoid contaminating or infecting personnel, the

environment, or other equipment, it is important to disinfect and decontaminate the monitor and any appropriate device accessories appropriately and remove the batteries. Then dispose of the device and accessories in accordance with your country’s regulations for equipment containing electronic parts.

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ECG Monitoring

• Implanted pacemakers might cause the heart rate meter to count the pacemaker rate during

incidents of cardiac arrest or other arrhythmias. Dedicated pacemaker detection circuitry may not detect all implanted pacemaker spikes. Check the patient's pulse; do not rely solely on heart rate meters. Patient history and physical examination are important factors in determining the presence of an implanted pacemaker. Pacemaker patients should be carefully observed. See “Pacemaker Pulse Rejection:” on page A-3 of this manual for disclosure of the pacemaker pulse rejection capability of this instrument.

• Use only ECG electrodes that meet the AAMI standard for electrode performance

(AAMI EC-12). Use of electrodes not meeting this AAMI standard could cause the ECG trace recovery after defibrillation to be significantly delayed.

• Do not place electrodes directly over an implanted pacemaker.

• The Propaq M unit detects ECG electrical signals only. It does not detect a pulse (effective

circulatory perfusion). Always verify pulse and heart rate by physical assessment of the patient. Never assume that the display of a nonzero heart rate means that the patient has a pulse.

• Excessive artifact can result due to improper skin preparation of the electrode sites. Follow

skin preparation instructions in Chapter 6: “Monitoring ECG.”

• Equipment such as electrocautery or diathermy equipment, RFID readers, electronic article

surveillance (EAS) systems, or metal detectors that emit strong radio frequency signals can cause electrical interference and distort the ECG signal displayed by the monitor, thereby preventing accurate rhythm analysis. Ensure adequate separation between such emitters, the device, and the patient when performing rhythm analysis.

• Shock Hazard: Use of accessories, other than those specified in the operating instructions,

may adversely affect patient leakage currents.

• Certain line-isolation monitors may cause interference on the ECG display and may inhibit

heart rate alarms.

Warnings

Pulse Oximeter

• Keep the ZOLL finger probe clean and dry.

• SpO

tricuspid regurgitation or obstructed venous return.

• SpO

vasoconstriction or hypovolemia or under conditions where there is no pulsating arterial vascular bed.

• SpO

devices, IR lamps, bright lights, improperly applied sensors; the use of non-ZOLL sensors, or damaged sensors; in patients with smoke inhalation, or carbon monoxide poisoning, or with patient movement.

• Tissue damage can result if sensors are applied incorrectly, or left in the same location for an

extended period of time. Move sensor every 4 hours to reduce possibility of tissue damage.

• Do not use any oximetry sensors during MRI scanning. MRI procedures can cause

conducted current to flow through the sensors, causing patient burns.

• Do not apply SpO

sound when the arterial circulation is cut off during NIBP measurements, and may affect SpO

• In some instances, such as obstructed airway, the patient's breathing attempts may not

produce any air exchange. These breathing attempts can still produce chest size changes, creating impedance changes, which can be detected by the respiration detector. It is best to use the pulse oximeter whenever monitoring respirations, to accurately depict the patient's respiratory condition.

measurements may be affected by certain patient conditions: severe right heart failure,

measurements may be affected when using intravascular dyes, in extreme

measurements may be affected in the presence of strong EMI fields, electrosurgical

sensor to the same limb that has an NIBP cuff. The SpO2 alarm may

measurements.

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Chapter 1 General Information

Noninvasive Blood Pressure

• Only a physician can interpret pressure measurements.

• Blood pressure measurement results may be affected by the position of the patient, his or her

physiological condition and other factors.

• Substitution of a component different from that supplied by ZOLL (e.g., cuff, hoses, etc.)

may result in measurement error. Use only ZOLL-approved cuffs and hoses. To avoid the risk of intravenous line misconnection and possible introduction of air into a patient’s blood, do not modify the NIBP system or hoses with Luer Lock adapters.

• Do not use a blood pressure cuff on the limb being used for IV infusion or for SpO

monitoring.

• Accurate pressure readings may not be achieved on a person experiencing arrhythmias,

shaking, convulsions or seizures. Medication may also affect pressure readings. The correct size cuff is essential for accurate blood pressure readings.

• Blood pressure hoses must be free of obstructions and crimps.

• If the patient’s cuff is not at heart level, an error in measurement may result.

• When monitoring blood pressure at frequent intervals, observe the cuffed extremity of the

patient for signs of impeded blood flow.

• Do not monitor one patient’s NIBP while monitoring another patient’s ECG.

• Blood pressure measurement may be inaccurate if taken while accelerating or decelerating

in a moving vehicle.

• If an NIBP measurement result is questionable or “motion” indication is displayed, repeat

the measurement. If the repeated measurement result is still questionable, use another blood pressure measurement method.

• Do not use the NIBP on cardiopulmonary bypass patients.

IBP

• To ensure compatibility and electrical safety, accessory pressure sensors should comply with

ANSI/AAMI BP-22 and IEC 60601-2-34 for IBP or ANSI/AAMI NS28 for ICP.

• Follow instructions supplied with any accessory pressure sensor regarding calibration and

removal of trapped air.

• Avoid touching metal parts of any transducer while it is in contact with the patient.

• Do not reuse any components that are labeled for single use only.

• Transducers should be rated to withstand an accidental drop of at least a meter onto a hard

surface.

• Transducers that are subject to immersion in liquids should be rated as watertight.

• During MRI scanning, the monitor must be placed outside the MRI suite. When the monitor

is used outside the MRI suite, EtCO2 monitoring can be implemented using a long

FilterLine

• When using the monitor with anesthetics, nitrous oxide or high concentrations of oxygen,

which permits placement of the monitor outside the MRI suite.

connect the gas outlet to a scavenger system.

• Use only Oridion Microstream CO

• Microstream CO

sampling lines are labeled for single patient use only. Do not reuse

sampling lines.

• If using the CO

Monitor for extended critical care, replace the airway adapter every 24

hours or when it becomes occluded.

• CO

readings and respiratory rate can be affected by sensor application errors, certain

ambient environmental conditions, and certain patient conditions.

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Respiration

• Do not operate the Propaq M with any other monitor with respiration measurements on the

same patient. The two devices could affect the respiration accuracy.

• The device should not be used as an apnea monitor.

Ferromagnetic Equipment

Biomedical equipment and accessories, such as ECG electrodes, cables, and oximeter probes contain ferromagnetic materials. Ferromagnetic equipment must not be used in the presence of high magnetic fields created by magnetic resonance imaging (MRI) equipment.

The large magnetic fields generated by an MRI device can attract ferromagnetic equipment with an extremely violent force, which could cause serious personal injury or death to persons between the equipment and the MRI device.

Battery

• Although the device can operate with auxiliary power alone, ZOLL strongly recommends

that you operate the unit with a battery installed at all times. Operating the unit with a battery provides a backup in case of AC power shortage, and results in faster charge time. The battery can be automatically recharged while it is installed in the unit. Keep a fully charged spare battery pack with the monitor at all times.

• Test battery packs regularly. A battery that does not pass the ZOLL charger’s capacity test

might cause the Propaq M unit to shut down unexpectedly.

• If the Low Battery indication occurs at any time during operation, immediately replace the

battery pack.

• If the LOW BATTERY icon appears, plug the Propaq M unit into a power source or install a

fully charged battery pack. When the warning low battery shutdown prompt appears, immediately replace the battery pack with a fully charged pack or plug the Propaq M unit into a power source, as unit shut down due to a low battery condition is imminent.

• If mistreated, a battery pack might explode. Do not disassemble a battery pack or dispose of

it in fire.

Warnings

Operator Safety

• Do not use the Propaq M in the presence of oxygen-rich atmospheres, flammable

anesthetics, or other flammable agents (such as gasoline). Using the unit in such environments might cause an explosion.

• Do not use the unit near or within standing water. Electrical safety might be compromised

when the monitor is wet.

• The use of accessory equipment that does not comply with the equivalent safety

requirements of the Propaq M monitor could reduce the level of safety of the combined system. When choosing accessory equipment, consider the following:

• Use of the accessory in the patient vicinity.

• Evidence that the safety certification of the accessory has been performed in accordance

with the appropriate IEC (EN) 60601-1 and/or IEC (EN) 60601-1-1 harmonized national standards.

• Always check that the equipment functions properly and is in proper condition before use.

• To avoid the risk of electrical shock, do not allow printer to come into contact with other

conductive parts, such as equipment connected to the USB port.

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Chapter 1 General Information

Patient Safety

• This equipment should be connected to only one patient at a time.

• To ensure patient safety, do not place the monitor in any position that might cause it to fall

on the patient.

• To ensure patient safety, connect the Propaq M only to equipment with circuits that are

electrically isolated.

• Use only high-quality ECG electrodes.

• Do not use ECG electrodes if the gel is dried, separated, torn or split from the foil; patient

burns may result from using such electrodes.

• Check the expiration date on the electrode packaging. Do not use electrodes after their

expiration date.

• Excessive body hair or wet, diaphoretic skin can inhibit electrode coupling to the skin. Clip

excess hair and dry any moisture from the area where an electrode is to be attached.

• Carefully route the patient cables away from the patient’s neck to reduce the possibility of

patient entanglement or strangulation.

• To avoid electrosurgery burns at monitoring sites, ensure proper connection of the

electrosurgery return circuit so that a return path cannot be made through monitoring electrodes or probes.

• During electrosurgery, observe the following guidelines to minimize electrosurgery unit

(ESU) interference and provide maximum operator and patient safety:

• Keep all patient monitoring cables away from earth ground, ESU knives, and ESU

return wires.

• Use electrosurgical grounding pads with the largest practical contact area.

• Always ensure proper application of the electrosurgical return electrode to the patient.

• Check electrical leakage levels before use. Leakage current might be excessive if more than

one monitor or other piece of equipment is connected to the patient.

Cautions

• If the unit is to be stored longer than 30 days, remove the battery pack.

• Do not sterilize the monitor, or its accessories unless the accessories are labelled as

sterilizable.

• Do not immerse any part of the monitor in water.

• Do not use the monitor if excessive condensation is visible on the device. Wipe only the

outside with a damp cloth.

• Do not use ketones (such as acetone or MEK) on the monitor.

• Avoid using abrasives (including paper towels) on the display window.

• To achieve the specified level of protection against spilled or splashed liquids, thoroughly

dry all exposed surfaces of this device prior to operation or connections to auxiliary power.

• If liquids enter the device connectors, remove all liquid from the connectors and allow the

device to dry thoroughly prior to use.

• Grounding reliability can be achieved only when the equipment is connected to a receptacle

marked “HOSPITAL ONLY,” “HOSPITAL GRADE,” or equivalent. If the grounding integrity of the line cord or ac receptacle is questionable, operate the monitor using battery power only.

• Do not connect to an electrical outlet controlled by a wall switch or dimmer.

• For accurate ECG information, and to protect against noise and other interference, use only

internal current-limiting ECG cables specified or supplied by ZOLL.

• For continued safety and EMI performance, use only the line cord supplied by ZOLL.

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• Electrical installation of the room or the building in which the monitor is to be used must

comply with regulations specified by the country in which the equipment is to be used.

• Dispose of battery packs in accordance with national, regional and local regulations. Battery

packs should be shipped to a reclamation facility for recovery of metal and plastic compounds as the proper method of waste management.

Restarting the Monitor

Certain events require the Propaq M products to be restarted after they shut off or become inoperative (for example, when the battery runs down and the unit shuts off).

In such a case, always try to restore monitor operation as follows:

1. Press the power switch on the top of the unit to turn it off.

2. If necessary, replace a depleted battery with a fully charged pack, or connect the monitor to

auxiliary power.

3. Press the power switch on the top of the unit to turn it back on.

This sequence is necessary to restart the monitor and can also be used to clear some fault messages when immediate use of the monitor is required.

If the Propaq M unit is powered off for less than 2 minutes, all patient monitoring parameter settings will be retained. If the unit has been powered off for at least two minutes, it will be considered a New Patient and all of the patient-specific parameters (alarm limits, etc.) will be reset to their default values.

Restarting the Monitor

Notification of Adverse Events

As a health care provider, you may have responsibilities under the Safe Medical Devices Act (SMDA), for reporting to ZOLL Medical Corporation, and possibly to the FDA, the occurrence of certain events.

These events, described in 21 CFR Part 803, include device-related death and serious injury or illness. In addition, as part of our Quality Assurance Program, ZOLL Medical Corporation requests to be notified of device failures or malfunctions. This information is required to ensure that ZOLL Medical Corporation provides only the highest quality products.

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Chapter 1 General Information

Software License

Note: Read this Operator’s Guide and License agreement carefully before operating any of

the Propaq M products.

Software incorporated into the system is protected by copyright laws and international copyright treaties as well as other intellectual property laws and treaties. This software is licensed, not sold. By taking delivery of and using this system, the Purchaser signifies agreement to and acceptance of the following terms and conditions:

1. Grant of License: In consideration of payment of the software license fee which is part of the price paid for this product ZOLL Medical Corporation grants the Purchaser a nonexclusive license, without right to sublicense, to use the system software in object-code form only.

2. Ownership of Software/Firmware: Title to, ownership of and all rights and interests in the

system software and all copies thereof remain at all times vested in the manufacturer, and Licensors to ZOLL Medical Corporation and they do not pass to purchaser.

3. Assignment: Purchaser agrees not to assign, sublicense or otherwise transfer or share its

rights under the license without the express written permission of ZOLL Medical Corporation.

4. Use Restrictions: As the Purchaser, you may physically transfer the products from one

location to another provided that the software/firmware is not copied. You may not disclose, publish, translate, release or distribute copies of the software/firmware to others. You may not modify, adapt, translate, reverse engineer, decompile, crosscompile, disassemble or create derivative works based on the software/firmware.

Service

NO IMPLIED LICENSE

Possession or purchase of this device does not convey any express or implied license to use the device with replacement parts which would, alone, or in combination with this device, fall within the scope of one or more of the patents relating to this device.

The Propaq M only requires recalibration of the CO2 module. Service is required after 20,000 hours of use of the CO

module. Appropriately trained and qualified personnel should,

however, perform periodic tests of the monitor functionality to verify proper operation.

If a unit requires service, contact the ZOLL Technical Service Department.

For customers In the U.S.A. For customers outside the U.S.A.

Telephone:

Fax:

1-800-348-9011 1-978-421-9655

1-978-421-0010

Call the nearest authorized ZOLL Medical Corporation representative.

To locate an authorized service center, contact the International Sales Department at

ZOLL Medical Corporation 269 Mill Road Chelmsford, MA 01824-4105

Telephone: 1-978-421-9655

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Service

When requesting service, please provide the following information to the service representative:

• Unit serial number

• Description of the problem

• Department using the equipment and name of the person to contact

• Purchase order to allow tracking of loan equipment

• Purchase order for a unit with an expired warranty

• Sample ECG or other stripcharts demonstrating the problem (if available and applicable),

less any confidential patient information.

Returning a unit for service

Before sending a unit to the ZOLL Technical Service Department for repair, obtain a service request (SR) number from the service representative.

Remove the battery pack from the unit. Pack the unit with its cables and battery in the original containers (if available) or equivalent packaging. Be sure the assigned service request number appears on each package.

For customers Return the unit to

In the U.S.A. ZOLL Medical Corporation

269 Mill Road Chelmsford, MA 01824-4105

Attention: Technical Service Department (SR number)

Telephone: 1-800-348-9011

In Canada ZOLL Medical Canada Inc.

1750 Sismet Road, Unit #1 Mississauga, ON L4W 1R6

Attention: Technical Service Department (SR number)

Telephone: 1-866-442-1011

In other locations The nearest authorized ZOLL Medical Corporation representative.

To locate an authorized service center, contact the International Sales Department at

ZOLL Medical Corporation 269 Mill Road Chelmsford, MA 01824-4105

Telephone: 1-978-421-9655

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Chapter 1 General Information

The ZOLL Serial Number

Each ZOLL product displays a serial number that contains information about that product. From left to right, ZOLL serial numbers are structured as follows:

• A two-character product code

• A three-character date-of-manufacture code

• A product serial number of six or more alphanumeric characters

The first two characters of the date-of-manufacture code give the last two digits of the year (for example, “06” appears for products manufactured in 2006). The last character of the date-ofmanufacture code gives the month in which the product was manufactured. The month appears in the form of a single alphanumeric character: “A” for January, “B” for February, “C” for March, and so on through “L” for December.

The product serial number is a unique set of alphanumeric characters that ZOLL assigns to each individual unit.

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Chapter 2

Product Overview

This chapter provides an overview of the Propaq M unit’s features, controls, and indicators. It provides illustrations of the Propaq M unit both with and without the optional printer.

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Chapter 2 Product Overview

Propaq M Controls and Indicators

Item Description

1 Handle Integrated carrying handle.

2 Front panel Includes the display screen and primary controls.

3 Speaker Emits R-wave detection beeps and alarm tones.

4 Patient connectors For details, refer to “Patient Cables and Connectors” on

page 2-8.

5 USB device connector For connecting the Propaq monitor to a USB device. For

details, refer to “Transferring Data to a USB Device” on page 14-3“.

6 Battery compartment Holds a rechargeable lithium ion battery pack.

7 Auxiliary power connector For connecting the device to an auxiliary power adapter.

8 Dock connector For connecting the device to a docking station.

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Propaq M with Printer (Optional) Control and Indicators

Item Description

1 Handle Integrated carrying handle.

2 Front panel Includes the display screen and primary controls.

3 Speaker Emits R-wave detection beeps and alarm tones.

4 Paper Compartment Holds paper for the printer (optional).

5 Patient connectors For details, refer to “Patient Cables and Connectors” on

page 2-8.

6 USB device connector For connecting the Propaq monitor to a USB device. For

details, refer to “Transferring Data to a USB Device” on page 14-3“.

7 Battery compartment Holds a rechargeable lithium ion battery pack.

8 Auxiliary power connector For connecting the device to an auxiliary power adapter.

9 Dock connector For connecting the device to a docking station.

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Chapter 2 Product Overview

Seven quick

Display screen

RFU indicator

Auxiliary power LED

Battery charge LED

Silence/reset

Display

Navigation keys

Snapshot

NIBP

access keys

Power button

Visual Alarm Indicators

The Front Panel

The front panel of all Propaq M devices includes the display screen, quick access keys, battery and auxiliary power indicators, and Ready For Use (RFU) indicator.

Propaq M Front Panel

Item Description

Display screen Shows therapeutic settings, physiological waveforms and other

information for each monitored parameter, messages, time, and quick access key labels.

Quick access keys Seven buttons control different functions of the unit. Labels for the quick

access keys appear on the monitor display to the right of each key.

Auxiliary power LED Illuminated when the unit is plugged in to an auxiliary power adapter.

Battery charge LED Indicates battery status:

Steady yellow: Battery is charging.

Steady green: Battery is charged.

Alternating green and yellow: The charge state cannot be determined

or a battery charging fault has been detected.

No light: Battery is not installed.

Visual alarm indicators

Red, yellow, and green lights located on the top of the unit that flash on and off when the unit is powered up and are used to indicate a patient alert, equipment alert, and data transfer.

NIBP button Starts/stops an NIBP measurement.

Snapshot button Records 24 seconds of numeric and waveform data.

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The Front Panel

Item Description

Navigation keys

Display/Home button Cycles through three available display modes or functions as an Home

The up ( ) arrow moves the cursor up through a vertical list or in a clockwise direction when navigating around the full screen.

The down ( ) arrow moves the cursor down through a vertical list or in

a counterclockwise direction when navigating around the full screen. You can also use the up and down arrows to modify parameter settings.

Use the Select button( ) to select a highlighted item on the display.

button when in a menu.

Audio Pause (Silence)/Reset button

RFU indicator

Ready Do Not Use

Power button Located on the top of the unit, this button turns the unit on and off.

Use to acknowledge a current alarm and pause (silence) the alarm audio for 90 seconds.

Pressing Audio Pause (Silence)/Reset button before the Audio Pause (Silence) period has expired resets the alarm.

Shows the status of the unit, based on its most recent readiness check.

A red circle with a line through it indicates that the unit’s readiness has been compromised and that it may not be ready for therapeutic use.

Note: The unit may display the message Check Sensor or searching...

when the unit is powered on, but the SpO2 sensor has not yet been connected to the patient. If SpO2 monitoring is desired, connect the SpO2 sensor to the patient. See Chapter 10, "Pulse CO-Oximetry (SpO2)" for information on Sp02 monitoring.

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Chapter 2 Product Overview

Date and time Patient mode

Battery status Time elapsed

Quick access keys

Message

Waveform

SpO

data

CO2 data

Respiration rate

NIBP data

Heart rate

Current temp

03/23/2012 12:34:56

Adult

00:17:43

I, II, III...

IBP

1 cm/mV

HR bpm

121

(96)

NIBP mmHg

CO2 mmHg

SpO2 %

T1 ºF

98.6

Status queue

Display Screen

The front panel includes a color display which shows:

• Date and time

• Patient mode

• Battery status indicator

• Time elapsed (since unit was turned on)

• Quick access keys

• Waveform source

• Color-coded waveforms and ECG lead identifiers

• SpO

• Heart rate numeric data

• Respiration rate numeric data

• Temperature numeric data

• Non-invasive blood pressure numeric data

• EtCO

• Invasive pressure numeric data

• Messages and prompts

numeric data

Fig. shows the layout of parameter values, waveforms, system data, and quick access key labels.

Propaq M Display Screen

Color coding

To differentiate information for various parameters, the unit displays each type of information in a specific user-configurable color.

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Battery Status and Auxiliary Power Indicators

Low

1:00+

2:00+

3:00+

The battery status indicator displays various battery icons to indicate the approximate remaining unit run time based on the charged state of the battery. Additionally, these icons provide indications of the status of the battery connection and communication with the unit. The auxiliary power indicator indicates that the unit is being powered by the auxiliary power adapter.

Note: Upon powering up the Propaq M unit, the battery capacity will be displayed within

approximately 15 seconds under normal conditions.

Icon Status Indication/Action

Auxiliary power adapter is connected

No battery detected Either there is no battery in the unit

Low battery capacity Replace the battery soon.

Communication failure The unit is unable to establish

Battery fault A battery fault has been detected.

The Front Panel

The unit is being powered by the auxiliary power adapter.

while it is being powered by the auxiliary power adapter, or the device cannot detect that the battery is connected.

communication with the battery and the battery capacity is unknown. Check the battery contacts.

Replace the battery.

Battery Level 1 The battery has less than one hour

of remaining battery capacity.

Battery Level 2 The battery has greater than one

hour of remaining battery capacity.

Battery Level 3 The battery has greater than two

hours of remaining battery capacity.

Battery Level 4 The battery has greater than three

hours of remaining battery capacity.

Battery Level 5 The battery is fully charged.

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Chapter 2 Product Overview

ECG

SpO

NIBP

Exhaust

IBP

Temp

USB

Patient Cables and Connectors

The left and right sides of the unit include sets of connectors for patient cables.

Note: The SPO2, NIBP, CO2, Temperature, and IBP functions are optional. If your unit does

not include these options, it does not have the applicable connectors.

Patient Cable Connectors on Left Side of Unit

Patient Cable Connectors on Right Side of Unit

Connector Description

ECG For connecting 3- or 5-lead ECG cable (12-lead monitoring is

optional).

SpO

NIBP For connecting NIBP hose.

Temp For connecting temperature probe(s).

USB For connecting the Propaq M monitor to a USB device.

IBP For connecting IBP cable(s).

For connecting Masimo SpO2/CO cable.

For connecting CO2 sampling line.

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Auxiliary Power Adapter

The auxiliary power adapter is used as backup power to operate the Propaq M unit. When it is connected to the unit, it powers the unit and charges the battery that is installed inside it. When the power cord is plugged in and the auxiliary power connector is inserted into the back of the Propaq M unit, the auxiliary power LED on the front panel illuminates and the auxiliary power icon displays at the top of the display screen.

Auxiliary Power Adapter

Caution Allow access to AC power cord as a means of disconnecting from AC mains power.

To connect the auxiliary power adapter, align the white arrow of the auxiliary power connector with the arrow on the input connector on the back of the unit and push it in. To disconnect the auxiliary power adapter, grasp the connector and pull it out.

Connecting the Auxiliary Power Adapter

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Chapter 2 Product Overview

I, II, III...

IBP

First level keys

Second level keys

I, II, III...

IBP

Navigating the Display Screen

You can access the Propaq M functions using the quick access keys that are located on the left side of the display screen, and the navigation keys that are located on the right side of the front panel.

Quick Access Keys

The seven quick access keys on the left side of the display screen are an easy way to access the functionality of the Propaq M. When you press the last key (left arrow), five more keys are displayed.

Quick access key Description

Lead Selects the ECG input source for the first waveform trace.

12 lead Displays the 12-lead monitoring screen.

LOG

IBP Displays IBP setup and zero buttons.

Print (Optional) Starts or stops a continuous chart print.

Turns CO2 on and off.

The Print quick access displays only when the Propaq M unit is equipped with a printer.

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Navigating the Display Screen

STOP

Row

Quick access key Description

More/Back Goes to the next or previous level of quick access keys.

Brightness Changes the brightness setting -- toggles through high contrast

display (white background), color display (black background), and night vision goggle (NVG) friendly display.

Treatment Displays the current clinical treatment options.

Alarms Displays the Limits option to allow the user to view/set all parameter

alarm limits and the alarm suspend button.

Log Opens the Log Control panel.

LOG

Setup Displays the Setup menu to allow the user to configure settings such

as ECG, display/volume, printer, trends, operational checklist, and supervisor.

Treatment Summary Displays treatment summary cases.

Trend Settings Displays settings for trend display format, trend on interval, and trend

on alarm.

Transfer Log Transfers the current data in the log to a USB drive.

Disclosure Log Transfer Use to transfer the Disclosure logs for up to 15 cases at a time to a

remote server for subsequent retrieval.

Clear Log Deletes the current data in the log.

Acquire Collects 10 seconds of 12-lead data or transmission.

Stop Acquisition Stops acquisition of 12-lead data.

Patient Information Allows you to enter information to accompany 12-lead data: patient

name, age, gender, and ID.

Row Up Allows you to move to the previous row when entering patient

information.

Row Down Allows you to move to the next row when entering patient information.

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Chapter 2 Product Overview

Exit

Stat

Set

Limits

Quick access key Description

12-Lead Review Reviews all your 12-lead captured data.

12-Lead Review Next Goes to the next page of the 12-lead snapshot you are reviewing.

Transmit Transmits 12-lead data.

12-Lead Staggered Print Allows you to print 12-Lead ECG data in four staggered 2.5 second

Exit 12-Lead Exits the 12-lead monitoring screen.

Stat Set Sets all alarm limits relative to the patient’s current vital signs.

Alarm Cancel Pauses (suspends) alarm audio.

segments.

Limits Displays the current alarm settings.

IBP Setup Brings up the IBP Control Panel for the corresponding channel (P1,

IBP Zero Zeroes the IBP transducer for the corresponding channel (P1, P2, or

Navigation Keys

Use the navigation keys (up/clockwise arrow, down/counterclockwise arrow, and select button) to navigate through windows and make selections.

Using Up/Clockwise and Down/Counterclockwise Arrows

Use the up/clockwise down/counterclockwise arrows to do the following:

• Move clockwise and counterclockwise through the main display windows.

• Move up and down in a window.

• Change parameter settings.

P2, or P3).

P3).

Using the Select Button

Use the Select button to do the following:

• Display the settings window while a parameter is highlighted in the main window.

• Select options from a window.

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Display Brightness Modes

The monitor can display in three different brightness modes:

• high contrast with white background (for optimal display in bright sunlight)

• color with black background (numerics and waveforms are easy to read)

• night vision goggle (NVG) friendly (display and alarm LEDs prevent interference with

goggles)

Common Tasks

The section contains procedures for the following tasks:

• “Setting the Date and Time” on page 2-13.

• “Replacing a Battery Pack on the Propaq M Unit (No Printer)” on page 2-15.

• “Using Treatment Buttons” on page 2-17

Setting the Date and Time

The Propaq M Set Date and Time screen allows you to set the date the Propaq M will use and its internal real time clock.

To set the Propaq M unit’s date and time:

Common Tasks

1. On the Propaq M display screen navigate to and select the Date and Time field. The Set Date And Time screen displays.

2. Specify the date by navigating to the date fields (Month, Day and Yea r ) and adjusting as

necessary.

3. Specify the unit’s time by navigating to the time fields (Hour, Minute, Seconds) and

adjusting as necessary. The selections available in the Hour field depend on whether your unit is configured for a 12 or 24 hour (default) clock.

Note: For systems with Clock Synchronization enabled, avoid changing the unit’s time

manually except at initial configuration.

4. When you are done indicating the date and time, select the Set Date and Time field to apply

your selections.

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Chapter 2 Product Overview

Set Date and Time Screen with Clock Synchronization

For systems with the Clock Synchronization feature enabled, the Set Date and Time screen indicates the date and time of the last synchronization to an external time source and allows you to adjust the clock for Daylight Saving Time. You can choose whether to enable Daylight Saving Time or not by selecting the Enable/Disable DST field as appropriate. Adjustments to Daylight Saving Time take effect immediately and must be manually adjusted at every transition between Standard Time and Daylight Saving Time. If enabled the clock will be adjusted forward by 1 hour. These fields only display on systems with the Clock Synchronization feature enabled. For information on Clock Synchronization, see “Configuring Clock Synchronization” on page 15-35.

Note: When Clock Synchronization is enabled, avoid changing the unit’s time manually

except at initial configuration.

Changing the Display Brightness

The following procedure shows how to select the different brightness options.

1. Press the power switch to turn the unit on.

2. Press the More/Back quick access key ( ).

3. Press the Brightness quick access key ( ) repeatedly to toggle through the brightness

options until you find your selection.

Note: Selecting a higher brightness setting (such as 70%) will deplete the battery pack at a

faster rate than when choosing a lower brightness setting (such as 30%). To select the brightness setting, go to the Setup>Display/Volume>Display Brightness menu to adjust the display percentage.

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Replacing a Battery Pack on the Propaq M Unit (No Printer)

This section describes how to replace a battery pack on the Propaq M unit (no printer).

To remove a battery pack, use your fingers to grasp and raise the latch and pull the battery pack out of the compartment.

Removing a Battery Pack from Propaq M Unit (No Printer)

To install a battery pack:

1. Line up the battery so it will slide into the battery well.

2. Push the battery into place.

Common Tasks

Installing a Battery Pack into Propaq M Unit (No Printer)

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Chapter 2 Product Overview

Replacing a Battery Pack on the Propaq M Unit with Printer

This section describes how to replace a battery pack on the Propaq M equipped with the optional printer.

To remove a battery pack, use your fingers to grasp and raise the latch and pull the battery pack out of the compartment.

Removing a Battery Pack from Propaq M Unit with Printer

To install a battery pack:

1. Line up the battery so it will slide into the battery well.

2. Push the battery into place.

Installing a Battery Pack into Propaq M Unit with Printer

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Using Treatment Buttons

Common Tasks

Pressing the Treatment quick access key ( ) causes the unit to display preconfigured buttons

that contain clinical actions. These buttons allow you to add a treatment snapshot (which itemizes drugs or treatments administered to the patient) to a Treatment Summary Report. When the Propaq M device is equipped with a printer, you can do this by selecting Print on Treatment Snapshot from Setup>Supervisor>Printer.

The following is a list of preconfigured treatment buttons:

• O2

• ASA

• Nitro

• Morph

• IV

• B Block

• Lido

• MgSO4

• Va l iu m

• Sedate

Customizing Treatment Buttons

You can also customize up to 9 treatment buttons by pressing the Setup quick access key ( ), and then selecting Supervisor>Log>Treatment Options. Highlight Define Custom Labels, and then can customize up to 9 buttons.

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Monitoring Overview

This chapter provides an overview of the Propaq M unit’s monitoring functions. It describes the types of vital sign monitoring that Propaq M provides, and the flexibility that the Propaq M unit gives you in displaying a patient’s vital signs information.

Propaq M Monitoring Functions

The Propaq M unit provides an array of standard, and optional, monitoring functions, and allows you to view the vital signs measurements that these functions provide in a variety of formats. The Propaq M unit also allows you to set alarm limits for each monitoring function. Should a patient’s vital signs measurements go outside of these limits, the Propaq M issues an audible alarm tone and displays visual alarm indications to alert you.

If the Propaq M unit is powered off for less than 2 minutes, all patient monitoring parameter settings are retained. If the Propaq M unit is powered off for 2 minutes or longer, the unit operates as if there is a New Patient and all patient-specific parameters (alarm limits, etc.) are reset to their default values.

Chapter 3

The Propaq M unit can monitor the following patient vital signs:

• ECG

• Heart Rate

• Respiration Rate

• Temperature

• Invasive Pressures (IBP)

• Non-invasive Blood Pressure (NIBP)

• Capnography (CO

• Pulse Oximetry (SpO

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)

Chapter 3 Monitoring Overview

ECG

An ECG waveform trace appears at the top of the display area. You can specify that the unit display the waveform trace of any available ECG source, such as ECG Leads on, in this area. You can configure the Propaq M unit to display up to four ECG waveform traces. In addition to being able to specify the ECG source for each waveform trace, you can adjust the display scale of those traces to make them easier to view.

Heart Rate

A Heart Rate meter gives the patient’s heart rate in Beats Per Minute (bpm). By default, the Propaq M unit derives the heart rate from the patient’s ECG, but can be configured to use other monitoring functions to derive the patient’s heart rate.

Respiration Rate

A Respiration Rate meter gives the patient’s respiration rate in Breaths Per Minute (br/min). The Propaq M unit can be configured to derive the respiration rate from the patient’s ECG or from the optional CO

monitoring function.

l, ll, or lll, and so

Temperature

The Temperature (Tem p) meter can display temperature measurements from up to two temperature probes. The Propaq M unit provides two separate temperature monitoring channels and, if both are used, displays the monitored temperatures, in degrees F or C, one after the other, followed by the difference between those temperatures.

Invasive Pressures (IBP)

The Propaq M unit provides three separate channels for monitoring arterial, venous, or intracranial pressure using internal probes. The pressure measurements for each pressure channel appear in a labeled (

P1, P2, P3) numeric display.

Non-Invasive Blood Pressure (NIBP)

The Propaq M unit provides patented Smartcuf motion-tolerant technology for NIBP monitoring. NIBP monitoring measures the patient’s systolic, diastolic, and mean blood pressure through an inflatable blood pressure cuff that the Propaq M unit inflates/deflates. NIBP measurements can be taken automatically or on-demand by pressing the NIBP button

( ) on the front panel of the Propaq M unit. The blood pressure measurements appear in a labeled ( invasive pressure waveforms in the waveform trace area.

NIBP) numeric display. You can also specify that the Propaq M unit display non-

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Capnography (CO2)

CO2 monitoring measures the CO2 concentration in a patient’s exhaled breath (End Tidal Carbon Dioxide --EtCO CO

concentration in the gasses supplied to intubated patients (Fractional Inspired Carbon

Dioxide -- FiCO serves as an indicator for rebreathing in non-intubated patients. CO both intubated and non-intubated patients.

Propaq M Monitoring Functions

). CO2 monitoring can also measure a patient’s breath rate and the

). Since FiCO2 represents the amount of CO2 present during inhalation, it also

monitoring can be used for

The EtCO

, breath rate, and FiCO2 measurements appear in a labeled (EtCO2) numeric

display. The EtCO mercury (mmHg). You can also specify that the Propaq M unit display a CO waveform trace display area.

Pulse Oximetry (SpO2)

Pulse Oximetry monitoring measures the oxygen saturation (SpO2) of arterial blood at a peripheral site such as a finger or toe. If optional features SpCO (carboxhemoglobin saturation)

and SpMet (methemoglobin saturation) or SpHb (total hemoglobin), SpOC (oxygen content), PVI (pleth variability index) and PI (perfusion index) are installed, it also monitors these parameters.

monitoring determines the ratio of oxygenated hemoglobin to total hemoglobin in arterial

SpO

blood and displays this ratio as percent SpO features SpCO and SpMet or SpHB, SpOC, PVI and PI are installed, these values alternate and

display under the SpO plethysmograph in the waveform trace display area.

and FiCO2 measurements can appear as values given in millimeters of

capnogram in the

in a labeled (SpO2) numeric display. If optional

display. You can also specify that the Propaq M unit display an SpO

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Chapter 3 Monitoring Overview

I, II, III...

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IBP

Monitoring Display Options

The Propaq M unit gives you great flexibility in how you display a patient’s vital signs

information. By pressing the Display/Home button ( ) on the front panel, you can successively display the patient’s vital signs information in these three windows:

• Waveform Display window, which initially displays an ECG waveform trace and numeric

displays for each monitoring function.

• Trends Status window, which displays a report listing vital signs measurements that the

Propaq M unit logs automatically, and the primary ECG waveform trace.

• Large Numerics Display window, on which large numeric displays of all vital signs

measurements appear.

The Waveform Display window appears when you power on the Propaq M unit. Initially, the Waveform Display window displays a single ECG waveform trace. All other monitored values appear in numeric display areas at the bottom of the screen:

You can display up to four waveform traces that you specify on the Waveform Display window. You will determine how to add waveform traces to this window later in this chapter.

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Monitoring Display Options

Adult

00:17:43

I, II, III...

IBP

1 cm/mV

HR bpm

NIBP mmHg

121 79

(96)

EtCO2 mmHg

SpO2 %

T1 ºF

NIBP Trends

Time HR/PR

bpm

NIBP

mmHg

SpO2

RR/BR

br/min

12:20:21 81

122/60 (85) 1597

12:15:21 73

124/63 (86) 1397

12:30:21 72

122/60 (85) 1297

12:25:21 80

122/60 (85) 1496

Adult

00:17:43

I, II, III...

T1 ºF

mmHg

121 79

(96)

25 9

(15)

HR bpm

NIBP mmHg

121

(96)

23:45

SDM

IBP

EtCO2 mmHg

SpO2 %

Press the Home/Display button when viewing the Waveform Display window, and the unit displays the Trends Status window. The Trends Status window reports the patient’s vital sign measurements, which the Propaq M logs automatically at a configurable interval (see the following chapter, Trends, for more detailed information about the Trends Status window). The primary ECG waveform trace appears above the Trends

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report:

98.6

Press the Home/Display button when viewing the Trends Status window and the Large Numerics Display window appears. The patient’s vital signs measurements appear in large labeled numeric displays; no waveform trace appears on this screen:

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Press the Home/Display button to redisplay the Primary Display window.

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Chapter 3 Monitoring Overview

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Adult

00:17:43

I, II, III...

IBP

1 cm/mV

HR bpm

121

(96)

NIBP mmHg

CO2 mmHg

SpO2 %

T1 ºF

98.6

III

aVL aVF

Insert

Source

aVR

Cascade

Configuring the Waveform Display

You can display up to four waveform traces on the Waveform Display window. The first waveform trace always uses an ECG lead as its source (such as Leads default is to another ECG lead for the first trace. As you insert the remaining three traces, you can specify that the traces use an ECG lead as the waveform source, or that the trace derive its waveform from other available monitoring functions (such as or

If configured, the unit can display four ECG traces on startup, when no other monitoring devices are attached.

The Propaq M unit can also cascade a trace onto the adjoining trace area to double the duration of the trace display.

Pads). If Pads are not connected, the unit can be configured to automatically default

P3).

l, ll, or lll, and so on. The

Resp, CO2, SpO2 or IBP channels P1, P2,

On the Waveform Display window, to insert a new trace ( displayed trace, highlight and select the trace label above the trace. In the following example, the unit is configured to cascade the ECG Lead l trace:

Insert) or cascade (Cascade) a

Note: The Propaq M unit automatically inserts a new waveform when you turn on a

parameter (CO automatically removes a waveform when you turn off a parameter or remove a sensor

and the unit displays the resulting equipment alert.

) or a new sensor signal is present (SPO2, IBP). The Propaq M unit

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Configuring the Waveform Display

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Adult

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I, II, III...

IBP

1 cm/mV

HR bpm

121

(96)

NIBP mmHg

CO2 mmHg

SpO2 %

T1 ºF

98.6

When the unit cascades the ECG Lead lI trace, the Waveform Display window appears as follows:

The following screens demonstrate how to insert two more waveform traces into the window. A third trace is inserted for ECG lead that when the third trace is inserted, the numeric displays move to the right side of the window to allow more room for the waveform traces.

aVR, and fourth trace for EtCO2 (a capnogram). Notice

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Chapter 3 Monitoring Overview

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Adult

00:17:43

I, II, III...

IBP

1 cm/mV

HR bpm

121

(96)

NIBP mmHg

CO2 mmHg

SpO2 %

T1 ºF

98.6

III

aVL aVF

Insert

Source

Cascade

aVR

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I, II, III...

IBP

1 cm/mVaVR

1 cm/mV

HR bpm

NIBP mmHg

121 79

(96)

EtCO2 mmHg

SpO2 %

T1 ºF

98.6

Inserting a third waveform trace for ECG lead aVR:

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Inserting a capnogram (CO2) into the fourth trace area:

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Adult

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I, II, III...

1 cm/mV aVR

1 cm/mV

HR bpm

NIBP mmHg

121 79

(96)

EtCO2 mmHg

SpO2 %

T1 ºF

98.6

III

aVR

aVL aVF

SpO2

Source

P1 P2 P3

Insert Cascade Remove

Resp CO2

IBP

Adult

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I, II, III...

CO2

0 to 60 mmHg

1 cm/mV

avR

IBP

1 cm/mV

HR bpm

NIBP mmHg

121 79

(96)

EtCO2 mmHg

SpO2 %

T1 ºF

Configuring the Waveform Display

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98.6

Chapter 4

Trends

The Propaq M unit accumulates a patient’s trend information by logging all monitored vital sign measurements to memory at a user-configurable interval. It also logs all monitored vital sign measurements when the following occurs:

• An NIBP measurement is taken and the Trend on NIBP option is on

• You press the Snapshot button ( ) on the front panel

• A patient alarm occurs and the Trend on Alarm option is on

The Propaq M unit can store at least 24 hours of trend information when logged at a 1 minute trend interval. You can view or save to external memory all logged trend information.

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Chapter 4 Trends

Navigate Here to Scroll Through Trends

Adult

00:17:43

I, II, III...

IBP

1 cm/mV

HR bpm

121

(96)

NIBP mmHg

CO2 mmHg

SpO2 %

T1 ºF

NIBP Trends

Time HR/PR

bpm

NIBP

mmHg

SpO2

RR/BR

br/min

12:20:21 81

122/60 (85) 1597

12:15:21 73

124/63 (86) 1397

Navigate Here to Scroll Through Trends

12:30:21 72

122/60 (85) 1297

12:25:21

Displaying the Trends Status Window

The Propaq M unit displays the logged trend information in the Trends status window. Press the

Display/Home button ( ) to display the Trends window, the primary ECG trace, and the small numeric displays for each monitoring function:

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98.6

The Trends status window displays the logged trend information and the time at which the trend measurements were logged. While trend measurements are logged to memory at a 30-second interval, the Trends status window can display the logged information at an interval that you specify, with the exception of NIBP measurements, which are logged and reported at the times they are taken. The Trends status window reports the trends information at 5-minute intervals.

To navigate in the Trends status window:

1. Use the navigation keys to highlight the press Select.

2. Press the Up/Down buttons to scroll through the trend information.

Trends Status window

Navigate Here to Scroll Through Trends bar, then

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Printing Trend Information

Trends

Printed trends are useful for reviewing the patient’s vital signs over the last several minutes to the last five hours. You can print vital signs data at one selected time or a trend summary showing vital signs values acquired during the current case (up to the last 24 hours).

Printing Trend Summary

To print a trend summary of all trends for the current patient:

1. Use the navigation keys to highlight the NIBP Trends field and press Select. The Trend Settings menu displays.

2. Highlight the Print Trend Summary field and press Select. The Trend Summary Report

begins printing.

3. To cancel the report, highlight Cancel Report and press Select.

Printing an Individual Trend Snapshot

To print an individual trend snapshot:

1. Highlight the Navigate here to scroll through trends field at the bottom of the Trends window and press Select.

2. Using the navigation keys, select the trend snapshot you want to print and press Select.

3. Highlight Print this Trend and press Select. The trend snapshot begins printing.

Printing Trend Information

Printing The 10 Most Recent Trend Snapshots

To print the 10 most recent trends for the current patient:

1. Press the Log quick access key ( ) then press the Print Trends button ( ). The Trend

LOG

Summary menu displays.

2. Navigate to and select the Select 10 Most Recent button.

3. Navigate to and select the Print Trend Summary button. The 10 most recent trends print for

the current patient.

Printing Specific Trend Snapshots

To print a trend summary for one or more cases:

1. Press the Log quick access key ( ) then press Print Trends ( ). The Trend Summary

LOG

menu displays.

2. Use the navigation keys to select the case or cases you want to print and press Select. A check

mark displays next to the selected case(s).

3. Highlight the Print Trend Summary field and press Select. The trend data for all the

selected cases begins printing.

Changing the Trends Status Window Display

By default, the Trends status window displays all logged trend information. It displays the numeric information for all monitoring functions, which the unit logs at a 30-second interval,

and when you take NIBP measurements, when a patient alarm occurs, and when you press .

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Chapter 4 Trends



To configure the display of the Trends status window, press ( ) and press the Trend Settings

quick access key ( ) to display the Trends Settings control panel. On the Trends Settings control panel, select

Trend Display Format to specify the following monitored vital signs that

appear in the Trends status window:

Trend Format Vital Signs Displayed

Resp HR, SpO2, RR, EtCO2, FiCO2

SpO2 HR, SpO2, SpCO, SpMet

SpHb HR, SpO2, SpHb, SpOC, PVI

NIBP HR, SpO2, NIBP, RR

IBP1 HR, SpO2, IBP1, RR

IBP2 HR, SpO2, IBP2 RR

IBP3 HR, SpO2, IBP3, RR

Te mp

HR, SpO2, T1, T2, T

Continuous Waveform Recording

LOG

Continuous waveform recording allows you to record continuous waveforms to a full disclosure case log for the patient being monitored. This feature needs to be enabled by a supervisor. The supervisor can access this feature by pressing the Setup quick access key ( ), and then selecting Supervisor>Log>Waveform Recording. In this menu, the following settings can be customized:

• Record Displayed Waveforms – Record only the top waveform that is displayed or record

all waveforms that are displayed.

• Record Additional Waveforms – Always record the CO

IBP and the CO

waveforms.

waveform or always record the

Note: When Continuous waveform recording is disabled, no waveforms (except snapshots)

are recorded.

The full disclosure case can, at a minimum, concurrently store the following information:

• 32 monitor snapshots

• 500 non-ECG events

• 24 hours of continuous ECG (4 waveforms), Capnography and IBP (3 channels)

Note: The actual information that is stored depends on usage. Also, the specific combination

of stored continuous waveform data depends on how the waveform recording settings are configured in the Supervisor menu.

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Chapter 5

Alarms

The Propaq M unit supports the detection and indication of patient alarms and technical alerts.

A patient alarm is any alarm condition that is caused by a monitored patient-related variable, such as a measured vital sign that falls outside of a configured alarm limit. You can configure

patient alarm limits for each of the physiologic monitoring functions.

A technical alert is monitored equipment-related variable that the Propaq M unit can detect, such as a disconnected sensor, internal diagnostics failures, and so on. Technical alerts are always enabled and are not user-configurable.

Patient alarms are always classified as high-priority alarms. Urgent technical alerts are classified as medium priority alarms. Other equipment status messages are classified as information signals.

Alarm conditions from patient alarms and technical alerts are stored in the Event Log and retained with normal power down or total loss of power.

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Chapter 5 Alarms

Visual Alarm Indicators

In addition to status messages that appear on the display, the Propaq M unit lights the red or yellow LED on the front panel to indicate the priority level of the highest-priority active alarm. The Propaq M LEDs indicate the priority level of the highest-priority active alarm as shown in the following table.

Active Alarm/Alert Priority Visual Alarm/Alert Indicator

High Priority -- Patient Alarm Flashing Red LED

Medium Priority -- Technical Alert Flashing Yellow LED

Information Signal; -- Equipment Status Message

Audible Alarm Indicators

The Propaq M unit sounds an audible alarm to indicate the priority level of highest-priority active alarm. The Propaq M indicates the priority level of the highest-priority active alarm by

sounding the audible alarm tones described in the following table.

Active Alarm/Alert Priority

High Priority -Patient Alarm

Medium Priority -Technical Alert

Information Signal-Equipment Status Message

Audible Alarm/Alert Indicator

Two sets of five short beep tones, repeated at 15-second intervals

One set of three longer beep tones, repeated at 30-second intervals

A single short beep tone, not repeated

Visual message only. No LED indicator

Alarm/Alert Volume (measured in accordance with ISO 3744)

Adjustable range:

Maximum Level > 69 dB(A)

Minimum Level > 61 dB(A)

Adjustable range:

Maximum Level >

Minimum Level > is 3 to 12 dBA below high priority alarm

Volume is at least 6 dBA below the medium priority alert

66 dB(A)

59 dB(A) Volume

Alarm Indicator Self-Test

The Propaq M unit performs a self-test of the audio and visual alarm indicators upon power-up. To ensure that the alarms and alerts are functioning properly, verify that two alarm tones are heard and the green, yellow, and red LEDs are illuminated upon power up.

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Patient Alarm Display

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IBP

1 cm/mV

HR bpm

121

(96)

NIBP mmHg

CO2 mmHgCO2 mmHg

SpO2 %

T1 ºF

98.6

EtCO2 Low Alarm

When a patient’s vital signs measurements trigger an alarm, in addition to sounding the patient alarm, the Propaq M unit displays an alarm message, and changes the display characteristics of the monitoring function’s numeric display (the alarming parameter appears in red against a white background).

Patient Alarm Display

In the following example, the EtCO alarm limit (

EtCO2 Low Alarm):

measurement (22 mmHg) has dropped below the lower

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Chapter 5 Alarms

Adult

00:17:43

I, II, III...

IBP

1 cm/mV

HR bpm

121

(96)

NIBP mmHg

CO2 mmHg

SpO2 %

Check Sensor

T1 ºF

SpO2 Check Sensor

Life Threatening Rhythm Alarms

When LTA monitoring is enabled, the Propaq M will monitor for the following life threatening ECG rhythms: asystole, ventricular fibrillation, ventricular tachycardia, extreme bradycardia, and extreme tachycardia.

Depending upon configuration of the unit, it generates visible and audible alarms as needed.

Equipment Alert Display

When a problem with the Propaq M unit or an attached sensor triggers an alert, in addition to sounding an equipment alert, the Propaq M unit displays an alert message (yellow background, black text).

Warning! Always respond immediately to a system alarm since the patient may not be monitored

during certain alert conditions.

In the following example, an equipment alert message indicates that the SpO2 sensor has become unattached (

SpO2 Check Sensor) from the unit:

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98.6

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Responding to Active Alarms -- Silencing the Alarm

When a patient alarm is triggered and the alarm tone sounds

1. Check the patient and provide appropriate care.

2. Press the Alarm Pause/Reset ( ) button on the Propaq M unit’s front panel to

acknowledge the alarm and briefly pause (silence) the alarm (90 seconds).

3. After caring for the patient, check that the appropriate alarms are set (for more information

about setting alarms, see appropriate monitoring chapters later in this manual).

Note: Pressing the Alarm Pause/Reset ( ) button pauses (silences) the alarm tone briefly

for all active alarms. If the patient’s vital signs measurements trigger another, different alarm, the patient alarm tone will sound, even if the first pause (silence) period hasn’t expired.

Re-enabling an Alarm

To re-enable an alarm before the alarm pause (silence) period has expired, press the Alarm

Pause/Reset ( ) button.

War ning! • Do not pause (silence) the audible alarm if patient safety may be compromised.

• Do not adjust alarm signal volume lower than the ambient noise level if this may impede

operator recognition of alarm signals.

Latching Alarms

High priority patient alarms can be configured to be latching or non-latching (default). When alarms are configured to be latching, alarm indicators (sound, message, color) remain whether or not the condition is present. Life Threatening Rhythm Alarms (LTA) are always latching. Latched alarms must be acknowledged even if the condition no longer exists. Latching alarms are useful in situations where the patient may not be continuously attended by the clinical operator as they make you aware of patient alarm conditions whether or not they are still occurring.

When alarms are configured as non-latching alarm indicators clear when the alarm condition ends, whether or not the alarm was Paused (Silenced).

Latching alarms are enabled or disabled (default) in the Setup>Supervisor>Alarms>General>menu.

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Chapter 5 Alarms

Pausing (Suspending) Alarms

If you want to temporarily prevent potential or current patient alarms and equipment alert alarms from sounding when caring for a patient, you can pause (suspend) alarm audio.for 2, 4, or 15 minutes (depending on your unit configuration) or you can pause (suspend) the alarm audio indefinitely (Audio Off). Alarms automatically resume after the configured pause (suspend) time is up.

To pause (suspend) patient alarms:

1. Press the More quick access key ( )to access the second set of quick access keys.

2. Press the Alarms quick access key ( ).

3. If you would like to pause (suspend) alarms for the configured amount of time, press

quick access key once. The Alarm Audio Paused icon ( ) appears at the top of the display next to the message area along with a timer indicating the amount of time the alarms will be paused.

4. If you would like to turn the alarm audio off indefinitely, press the quick access key a

second time. The Alarm Audio Off icon ( the message area to indicate alarm audio is paused indefinitely for this unit.

Note: Press the quick access key a third time to clear the display and resume alarm

audio.

) appears on the top of the display next to

No alarms will sound while alarms are paused (suspended); however, if an alarm occurs during the suspension period, the Propaq M unit will display visual alarm indicators -- alarm messages in the message area (white text on a red background) and red/white numeric displays).

Note: Your Propaq M unit may be set up to not allow pausing (suspending) alarms.

Warning! When audible alarms are disabled, make sure that the patient is closely observed.

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Alarm Reminders

Setup > Supervisor > Alarms

Default Neonate

General

Default Adult

Default Pediatric

Your unit may be configured to sound a Reminder Alarm at specified intervals. When the Reminder Alarm is enabled an alarm will sound every 5 (default), 10 or 15 minutes (depending on configuration) if an Audio Off condition persists. When Reminder Alarm is disabled, no reminders are issued if the Audio Off condition continues. You enable or disable the Reminder Alarm in the Setup>Supervisor>Alarms>General>menu.

Alarm Options

The Propaq M unit provides alarm options that you can specify through the Supervisor parameter control panel (access to Supervisor is passcode-controlled).

Press the More quick access key ( ), press the Setup quick access key ( ), and select

Supervisor SAVE when you are finished. Once you have entered your supervisor passcode, you will be

able to access the configurable options in the Supervisor menu.

Select Alarms to display the alarms parameter control panel:

Alarm Options

. Using the navigation keys, select the four digits in the Supervisor passcode. Press

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Alarms Parameter Control Panel

Chapter 5 Alarms

Stat

Set

Selecting Default Alarm Limits

The three options -- Default Adult, Default Pediatric, Default Neonate -- allow you to set all alarm limits to the Propaq M unit’s factory-specified default values, by patient type.

War ning! • A potential hazard exists if different alarm limits are used for the same or similar

equipment in any single area.

• Confirm the alarm limits are appropriate for the patient each time there is a new patient case.

• Do not set alarm limits to such extreme values that render the alarm system useless.

Setting Alarm Limits Relative to the Patient -- Stat Set Option

The Propaq M unit also allows you to set all alarm limits relative to the patient’s current vital signs measurements by performing the following actions:

1. Press .

2. Press the Alarm quick access key ( ).

3. Press the Stat Set quick access key ( ). The Propaq M unit sets all parameters to a new

value based on the current values as follows:

Parameter

(units)

HR/PR

(bpm)

IBP

(mmHg)

NIBP

(mmHg)

RR/BR

(/min)

Range Upper Limit Calculation Lower Limit Calculation

Numeric < 26 Limit is unchanged Limit = 25

26 Numeric  99

100  Numeric  250

Numeric > 250 Limit = 250 Limit is unchanged

Numeric < 26 Limit = Numeric + 5 Limit = Numeric – 5

26  Numeric  99

Numeric > 99 Limit = Numeric + 20 Limit = Numeric – 20

Numeric < 26 Limit = Numeric + 5 Limit = Numeric – 5

26  Numeric  99

Numeric > 99 Limit = Numeric + 20 Limit = Numeric – 20

Numeric < 26 Limit = Numeric + 5 Limit = Numeric – 5

26  Numeric  99

Numeric > 99 Limit = Numeric + 20 Limit = Numeric – 20

Limit = Numeric x 1.2 Limit = Numeric x 0.8

Limit = Numeric + 20 Limit = Numeric – 20

Limit = Numeric x 1.2 Limit = Numeric x 0.8

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Alarm Options

Parameter

(units)

SpO

(%)

SpCO

(%)

SpMet

(%)

SpHb (g/dL)

SpHb

(mmol/L)

SpOC

(ml/dL)

PVI (%)

(%)

EtCO

(mmHg)

FiCO

(mmHg)

Tem p

(°C)

Tem p

(°F)

Range Upper Limit Calculation Lower Limit Calculation

Entire range Limit = 100 (Adult and

Limit = Numeric – 5 Pediatric) Limit = Numeric + 5 (Neonate)

Entire range Limit = Numeric + 2

Upper limit 40

Entire range Limit = Numeric + 2

Upper limit 15

Limit = Numeric - 2

Lower limit 0

Limit = Numeric - 2

Lower limit 0

Entire range Limit = Numeric + 2 Limit = 0

Entire range Limit = Numeric + 1 Limit = 0

Entire range Limit = Numeric + 2 Limit = 0

Entire range Limit = Numeric + 5 Limit = Numeric - 5

Entire range Limit = Numeric + 2 Limit = 0

Entire range Limit = Numeric + 10 Limit = Numeric - 5 mmHg

unless the numeric falls

below the lower alarm limit

range, in which case Stat

Set sets the lower limit to

15 mmHg.

Entire range Limit = Numeric + 5 N/A

Entire range Limit = Numeric + 0.5 Limit = Numeric – 0.5

Entire range Limit = Numeric + 0.9 Limit = Numeric – 0.9

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Chapter 6

Monitoring ECG

This chapter describes how to use the Propaq M unit to monitor ECG.

You can use a 3-lead, 5-lead, or 12-Lead wire configuration for ECG monitoring (see Chapter 14, “12-Lead ECG Interpretive Analysis” for more information on 12-lead monitoring).

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Chapter 6 Monitoring ECG

War ning! • Excessive body hair or wet, sweaty skin may interfere with electrode adhesion. Remove

the hair and/or moisture from the area where the electrode is to be attached.

• Use only electrodes that are well within the expiration date indicated on the package.

• Remove ECG electrodes from their sealed package immediately prior to use. Using

previously opened or out-of- date electrodes may degrade the ECG signal quality.

• Monitoring electrodes may become polarized during defibrillator discharge, causing the ECG waveform to briefly go off screen. ZOLL Medical Corporation recommends the use of high quality silver/silver chloride (Ag/AgCl) electrodes to minimize this effect; the circuitry in the instrument returns the trace to the monitor display within a few seconds.

• To assure protection against the effects of defibrillator discharge, use only ZOLL-approved accessories.

• To avoid a shock hazard and interference from nearby electrical equipment, keep electrodes and patient cables away from grounded metal and other electrical equipment.

• To avoid electrosurgery burns at monitoring sites, ensure proper connection of the electrosurgery return circuit so that the return paths cannot be made through monitoring electrodes or probes.

• Check the operation and integrity of the Propaq M unit and ECG cable regularly by performing the Daily Operational Verification Test.

• Implanted pacemakers may cause the heart rate meter to count the pacemaker rate during incidents of cardiac arrest or other arrhythmias. Carefully observe pacemaker patients. Check the patient's pulse; do not rely solely on heart rate meters. Dedicated pacemaker detection circuitry may not detect all implanted pacemaker spikes. Patient history and physical exam are important in determining the presence of an implanted pacemaker.

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ECG Monitoring Setup

The proper application and placement of electrodes is essential for high quality ECG monitoring. Good contact between the electrode and skin minimizes motion artifact and signal interference.

The following procedure describes how to monitor a patient’s ECG using 3- and 5-Lead ECG cables.

To monitor a patient’s ECG using 3- and 5-Lead ECG cables, perform the following steps:

1. Prepare the patient's skin for electrode application:

2. Apply the electrode pads to the patient.

3. Connect each lead of the ECG cable to the appropriate electrode.

4. Insert the patient cable plug into the ECG input connector on the Propaq M unit.

5. Select the ECG waveforms to be displayed on the waveform trace display screen.

6. Observe the patient‘s electrocardiogram on the display, and adjust size of the ECG waveform

trace, as necessary.

Preparing the Patient for Electrode Application

ECG Monitoring Setup

The proper application of electrodes is essential for high quality ECG monitoring. Good contact between the electrode and skin minimizes motion artifact and signal interference.

Before applying electrodes, prepare the patient’s skin, as necessary:

• Shave or clip excess hair at electrode site.

• Clean oily skin with an alcohol pad.

• Rub site briskly to dry.

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Chapter 6 Monitoring ECG

Applying Electrodes to the Patient

The following sections show where to place electrodes when using 3- and 5-Lead cables to perform ECG monitoring. For 3-Lead ECG cables, apply electrodes as in Figure 4-1, 3-Lead

Electrode Placement. For 5-Lead ECG cables, apply electrodes as in Figure 4-2, 5-Lead Electrode Placement.

Avoid placing electrodes over tendons and major muscle masses.

3-Lead Electrode Placement

Depending upon local usage, the ECG leads are marked either RA, LA, and LL (or R, L, and F). The following table shows the markings and color codes for the different lead sets.

AHA Color Coding IEC Color Coding Placement of Electrodes

RA/White Electrode R/Red Electrode Place near patient’s right mid-clavicular line,

LA/Black Electrode L/Yellow Electrode Place near patient’s left mid-clavicular line,

LL/Red Electrode F/Green Electrode Place between 6th and 7th intercostal

directly below clavicle.

space on patient’s left mid-clavicular line.

3-Lead Electrode Placement

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ECG Monitoring Setup

5-Lead Electrode Placement

Depending upon local usage, the ECG leads are marked either RA, LA, LL, RL, and V or R, L, F, N and C. The following table shows the markings and color codes for the different lead sets.

AHA Color Coding IEC Color Coding Placement of Electrodes

RA/White Electrode R/Red Electrode Place near patient’s right mid-clavicular line,

directly below clavicle.

LA/Black Electrode L/Yellow Electrode Place near patient’s left mid-clavicular line,

directly below clavicle.

LL/Red Electrode F/Green Electrode Place between 6th and 7th intercostal

space on patient’s left mid-clavicular line.

RL/Green* Electrode N/Black* Electrode Place between 6th and 7th intercostal

space on patient’s right mid-clavicular line.

V/Brown* Electrode C/White* Electrode Single movable chest electrode. Place this

electrode in one of the positions, V1 - V6, as shown in the following figure.

V1 -- 4th intercostal space at right sternal margin.

V2 -- 4th intercostal space at left sternal margin.

V3 -- Midway between V2 and V4 leads.

V4 -- 5th intercostal space at mid-clavicular line.

V5 -- Same transverse level as V4 at left anterior-axillary line.

V6 -- Same transverse level as V4 at left mid-axillary line.

5-Lead Electrode Placement

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Chapter 6 Monitoring ECG

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I, II, III...

IBP

Connecting the ECG Cable To the Propaq M Unit

The Propaq M unit accepts Welch Allyn Propaq® ECG cables as well as ZOLL Propaq M ECG cables. Connect the ECG cable to the ECG connector on the left side of the Propaq M unit as follows:

Connecting ECG Cable to Propaq M Unit

Selecting ECG Waveforms for Display

You can fit up to four waveforms on the Propaq M display. The first waveform at the top of the display is always an ECG waveform. (If automatically default to another ECG lead.) In the following example, Lead source of the ECG waveform trace:

Pads are not connected, the unit can be configured to

II (RA-LL), is the

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ECG Monitoring Setup

I, II, III...

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Adult

00:17:43

I, II, III...

IBP

1 cm/mV

HR bpm

121

(96)

NIBP mmHg

CO2 mmHg

SpO2 %

T1 ºF

98.6

III

aVL aVF

Insert

Source

Cascade

aVR

The unit is configured to display Pads by default for the top trace. If configured, the unit can also display four ECG traces on startup, when no other monitoring devices are attached.

The are two ways to specify which ECG lead is the source of the primary waveform trace. One

way is to press the ECG lead selection quick access key to display the available ECG waveform sources. The available waveform sources are determined by the type of ECG cable connected to the unit.

The other way to specify the source of the primary waveform trace is to navigate to and select the source label for the primary ECG waveform (Lead unit then displays the available ECG waveform sources. The following example illustrates the waveform source list that the Propaq M unit displays when a 5-lead ECG cable is connected to it. The list of available ECG waveform sources includes Leads You can select Lead displayed ECG lead as the source for the waveform trace.

lI (the default), or use the navigation keys to highlight and select another

l in the screen below). The Propaq M

I, II, III, aVR, aVL, aVF, and V.

Select a current waveform source, and the unit displays the waveform immediately. If you select a waveform source that is not currently available, the unit displays the message, LEAD FA U L T .

For more information on how to configure the display of waveforms on the Propaq M unit, see Chapter 3, Monitoring Overview.

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Chapter 6 Monitoring ECG

00:17:43

I, II, III...

IBP

1 cm/mV

HR bpm

121

(96)

NIBP mmHg

CO2 mmHg

SpO2 %

T1 ºF

0.125 cm/mV

1.0 cm/mV

4.0 cm/mV Auto

Lead II Size

0.50 cm/mV

2.0 cm/mV

0.25 cm/mV

Selecting the Waveform Trace Size

The Propaq M unit allows you to select the waveform trace size to adjust the size of displayed the ECG waveform.

To select the waveform size, use the navigation keys to highlight and select the trace size that appears to the right of the electrode label:

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Adult

98.6

The default trace size is

0.125, 0.25, 0.50 cm/mV) trace size. You can also specify that the Propaq M unit select a best-fit

( trace size (

AUTO).

1cm/mV. You can select a larger (2.0, 4.0 cm/mV) or smaller

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ECG Monitoring and Pacemakers

When the unit performs ECG monitoring on a patient with an implantable pacemaker, the unit’s Pacer indicator feature can indicate the occurrence of pacemaker signals.

ECG Monitoring and Pacemakers

If the Pacer Indicator setting is

• detects the implantable pacemaker pulses

• blanks the pacemaker pulses from the waveform—preventing them from disturbing the

ON, the Propaq M performs the following actions:

ECG waveform and allowing for an accurate QRS detection

• displays vertical dashed lines to indicate the detected pacemaker signals

If the Pacer Indicator setting is

• detect the implantable pacemaker pulses

• blank the pacemaker pulses from the waveform

• display the vertical dashed line pacer markers

You can turn the Pacer Indicator

To turn the Pacer Indicator

OFF, the Propaq M does not perform the following actions:

ON/OFF from the Setup>ECG menu.

ON/OFF:

1. Press the More quick access key ( ).

2. Press the Setup quick access key ( ).

3. Use the navigation keys to select ECG then press .

4. Use the navigation keys to highlight and select Patient Pace Marker then press .

5. Use the navigation keys to select On or Off as appropriate. When you select Off the Pacer

Off Indicator( ) icon appears in the top ECG trace on the Display Screen to indicate the pacer indicator is off. If the patient has a cardiac pacemaker the Paced Indicator should be set to On indicating that pace pulse detection is On.

There are situations where ECG artifact could simulate pacemaker signals which could cause false pacemaker detection and blanking. These situations may cause inaccurate QRS detection and it may be desirable to turn the Pacer Indicator setting is

OFF, implantable pacemaker signals may cause inaccurate QRS detection and it may

be desirable to turn the Pacer Indicator on.

ECG System Messages

When monitoring ECG, the Propaq M unit may display the following messages:

System Message Cause

LEAD FAULT The current ECG source lead is defective (check

Note: If an ECG Monitoring cable is intentionally disconnected, you can disable the Lead

Fault alarm by Pausing (Suspending) the alarm audio. See “Pausing (Suspending) Alarms” on page 5-6 for more information.

off. Inversely, when the Pacer Indicator

lead and replace, if necessary).

-- OR --

An unavailable waveform source has been specified for the trace display (check specified waveform source and correct, if necessary).

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Chapter 7

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Adult

00:17:43

I, II, III...

IBP

1 cm/mV

HR bpm

121

(96)

NIBP mmHg Resp br/min

SpO2 %

T1 ºF

98.6

Respiration Meter

Monitoring Respiration (Resp) and Heart Rate (HR)

This chapter describes how to use the Propaq M unit to monitor Respiration (Resp) and Heart

HR).

Rate (

The Propaq M unit displays Respiration (Resp) and Heart Rate (HR) meters. The Respiration and Heart Rate meters display values that the Propaq M unit derives from measurements taken by other Propaq M monitoring functions.

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Heart Rate Meter

Chapter 7 Monitoring Respiration (Resp) and Heart Rate (HR)

Respiration/Breath Rate Meter

If enabled, the Propaq M unit displays the patient’s respiration in the Respiration/Breath Rate Meter.

The respiration

monitoring function. If CO2 monitoring is not available, the unit derives the respiration

rate through impedance pneumography, using a specified ECG electrode configuration. If ECG monitoring isn’t functioning, the

meter displays the respiration rate that it derives, by default, from the unit’s

Resp/BR meter will not display a respiration rate.

Using Impedance Pneumography to Measure Respiration

Impedance pneumography detects respiration by applying a high-frequency, low-current AC signal to the patient and measuring the changes in impedance through ECG electrode Lead (RA-LA) or Lead increases; as the patient exhales, impedance decreases.

War ning! • Impedance pneumography detects respiratory effort through changes in chest volume.

However, No Breath episodes with continued respiratory effort may go undetected. Always monitor and set alarms for SpO

monitor respiratory function.

• With any monitor that detects respiratory effort through impedance pneumography, artifact due to patient motion, apnea mattress shaking, or electrocautery use may cause apnea episodes to go undetected. Always monitor and set alarms for SpO2 when using impedance pneumography to monitor respiratory function.

ll (RA-LL). As the patient inhales and chest volume expands, impedance

when using impedance pneumography to

• When using impedance pneumography, don’t use the Propaq M unit with another respiration monitor on the same patient, because the respiration measurement signals may interfere with one another.

• Impedance pneumography is not recommended for use on paced patients, because pacemaker pulses may be falsely counted as breaths.

• Impedance pneumography is not recommended for use with high frequency ventilation.

• Since impedance pneumography uses the same leads as the ECG channel, the

Propaq M unit determines which signals are cardiovascular artifact and which signals are the result of respiratory effort. If the breath rate is within five percent of the heart rate, the monitor may ignore breaths and trigger a respiration alarm.

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Configuring Respiration (RR/BR) Alarms and Settings

Limits

Configuring Respiration (RR/BR) Alarms and Settings

The Propaq M unit allows you to enable and disable the Respiration (RR/BR) Rate alarm, to set alarm limits, and to specify the ECG monitoring source for the Respiration rate.

Enabling/Disabling RR/BR Alarms and Setting Alarm Limits

When enabled, the Propaq M unit sounds alarms whenever the patient’s respiration rate is above or below the specified respiration rate alarm limits.

To enable (or disable) Resp alarms and set Upper and Lower alarm limits, you can either do so

through the Alarms quick access key ( ), or the Resp Parameter Control Panel.

To configure

RR/BR alarms through the Alarms quick access key:

1. Press .

2. Press .

3. Press the Limits quick access key ( ). Use the navigation keys to highlight and select the

RR/BR Alarm menu selection.

4. On the RR/BR Alarm Settings menu, use the navigation keys to select the fields that you want

to change:

• Upper Limit Enable

• Lower Limit Enable

• Upper Limit

• Lower Limit

5. When you are finished changing values on the alarm menu, navigate to the Backarrow key

to confirm your choices and exit the menu.

Respiration Rate Alarm Limits

Initially, the Resp Alarm Settings menu specifies that Resp alarms are enabled (ON) or disabled (OFF), and displays the default Upper and Lower respiration rate alarm limits. The upper and lower limits can be

ON or OFF (default is OFF).The following table lists the default

respiration rate alarm limits for adult, pediatric, and neonate patients, and gives the range in which you can set these limits:

Patient Type Respiration Rate Default Respiration Rate Range

Adult Lower: 3 br/min

Upper: 50 br/min

Pediatric Lower: 38 br/min

Upper: 50 br/min

Neonate Lower: 12 br/min

Upper: 80 br/min

Lower: 0 to 145 br/min

Upper: 5 to 150 br/min

Lower: 0 to 145 br/min

Upper: 5 to 150 br/min

Lower: 0 to 145 br/min

Upper: 5 to 150 br/min

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Chapter 7 Monitoring Respiration (Resp) and Heart Rate (HR)

Resp

Lower Upper

RR/BR Alarm 10

No Breath Alarm 30 sec

Resp Monitoring On

Resp Lead

Lead II (RA-LL)

CO2/Resp Sweep Speed

12.5 mm/s

Using the Resp Parameter Control Panel

To configure alarms through the Resp Parameter Control Panel, use the navigation keys to highlight and select the Respiration Rate meter and display the

Respiration Parameter Control Panel

Resp Parameter Control Panel:

The Resp Parameter Control Panel allows you to set the following parameters:

• RR/BR Alarm -- enable/disable the Resp alarm and set high/low alarm limits.

• No Breath Alarm -- sets the duration of the No Breath alarm, or disables alarm by selecting

“Off”.

• Resp Monitoring -- enable/disable respiration monitoring.

• Resp Lead -- selects the Resp lead, Lead I (RA-LA) or Lead II (RA-LL), from which the

Propaq M unit calculates the respiration rate. Resp Lead selection is independent of ECG Lead selection.

• CO2/Resp Sweep Speed -- sets the respiratory sweep speed on the display.

Enabling/Disabling Resp Monitoring

Select the Resp Monitoring prompt to enable or disable Resp monitoring. When Resp Monitoring is set to On (the default), the Propaq M unit displays the Respiration Rate Meter. When set to off, Propaq M removes the Respiration Rate meter from the display.

Warning! When using impedance pneumography, the Propaq M unit automatically rejects

cardiovascular artifact (CVA). This function requires the accurate ECG R-wave detection. Therefore, always select the ECG lead with the most prominent QRS complex when using impedance pneumography to monitor respiration.

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Heart Rate Meter

Limits

The Heart Rate meter displays the heart rate that it derives from the ECG monitoring function (by default) or from a monitoring function that you specify. If the ECG (or user-specified monitor function) measurements are not available, the Heart Rate meter derives the heart rate from the following monitoring functions, if they are available, in this order: User-selected default source, ECG, IBP channel 1, SpO2, IBP channel 2, IBP channel 3, and NIBP. The Heart Rate meter is labeled other source is used.

Heart Rate Meter

HR (as in the following example) if the source is ECG, and PR if any

Note: The Heart Rate meter displays heart rates below 20 as three dashes (

above 300 as three plus signs (

+++).

Configuring Heart Rate (HR) Meter Alarms

The Propaq M unit allows you to enable and disable the Heart Rate (HR) alarm, to set alarm limits, and to select a Heart Rate tone.

Enabling/Disabling HR Alarms and Setting Alarm Limits

When enabled, the Propaq M unit sounds alarms whenever the patient’s heart rate is above or below the specified heart rate alarm limits.

To enable (or disable) HR alarms and set Upper and Lower alarm limits, you can either do so

through the Alarms quick access key ( ) or the HR/PR Parameter Control Panel.

To configure HR alarms through the Alarms quick access key:

---) and heart rates

1. Press .

2. Press .

3. Press .

4. Use the navigation buttons to highlight and select HR/PR Alarm.

5. On the HR/PR Alarm Settings menu, use the navigation keys to select the fields that you want

to change:

• Upper Limit Enable

• Lower Limit Enable

• Upper Limit

• Lower Limit

When you are finished changing values on the alarm menu, navigate to the Backarrow key to confirm your choices and exit the menu.

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Chapter 7 Monitoring Respiration (Resp) and Heart Rate (HR)

Heart Rate (HR/PR) Alarm Limits

Initially, the HR/PR Alarm Settings menu specifies that alarms are enabled (ON) or disabled

OFF), and displays the default Upper and Lower heart rate alarm limits. The upper and lower

( limits can be

ON or OFF (default is OFF). The following table lists the default HR alarm limits

for adult, pediatric, and neonate patients, and gives the range in which you can set these limits:

Patient Type HR Default HR Rate Range

Adult Lower: 50 BPM

Upper: 120 BPM

Pediatric Lower: 50 BPM

Upper: 150 BPM

Neonate Lower: 100 BPM

Upper: 200 BPM

Life Threatening Rhythm Alarms

When LTA monitoring is enabled, the Propaq M unit will monitor for the following life threatening ECG rhythms: asystole, ventricular fibrillation, ventricular tachycardia, extreme bradycardia, and extreme tachycardia. These events are also displayed on Treatment Summary Reports and Alarm Snapshots.

The following example shows an Asystole alarm event:

Lower: 30 to 298 BPM

Upper: 32 to 300 BPM

Lower: 30 to 298 BPM

Upper: 32 to 300 BPM

Lower: 30 to 298 BPM

Upper: 32 to 300 BPM

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Configuring Heart Rate (HR) Meter Alarms

Limits

To enable or disable LTA alarms and set Extreme Brady/Tachy alarm limits, you can either do

so through the Alarms quick access key ( ), or the HR/PR Parameter Control Panel.

To configure LTA alarms through the Alarms quick access key:

1. Press .

2. Press .

3. Press . Use the navigation keys to highlight and select the fields that you want to change:

• LTA Monitoring

• Extreme Brady/Tachy Alarms

When you are finished changing values on the alarm menu, navigate to the Backarrow key to confirm your choices and exit the menu.

Extreme Bradycardia and Extreme Tachycardia Alarm Limits

The Extreme Brady/Tachy Alarm Settings menu specifies the configured delta values that are applied to the HR lower limit alarm and HR upper limit alarm for the Extreme Bradycardia and Extreme Tachycardia LTA alarm detection, respectively. For example, if the HR lower limit alarm is configured to 50 and the Extreme Brady delta value is configured to -10, the Extreme Bradycardia LTA detection threshold will be at 40 bpm. Likewise, if the HR upper limit alarm is configured to 120 and the Extreme Tachy delta value is configured to +20, the Extreme Tachycardia LTA detection threshold will be at 140 bpm. The HR lower and upper limit alarms are not required to be enabled for the Extreme Bradycardia and Extreme Tachycardia LTA alarm detection to be enabled. The Extreme Bradycardia and Extreme Tachycardia LTA alarms will not activate until 20 seconds after the alarm limit threshold is crossed.

The following tables list the default Extreme Bradycardia and Extreme Tachycardia alarm limits for adult, pediatric, and neonate patients, and the ranges in which you can set these limits:

Extreme Bradycardia Alarm Limits

Patient Type Default Delta Value Range

Adult -10 -5 to -30 in increments of 5

Pediatric -10 -5 to -30 in increments of 5

Neonate -10 -5 to -30 in increments of 5

Extreme Tachycardia Alarm Limits

Patient Type Default Delta Value Range

Adult +20 +5 to +30 in increments of 5

Pediatric +20 +5 to +30 in increments of 5

Neonate +20 +5 to +30 in increments of 5

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Chapter 7 Monitoring Respiration (Resp) and Heart Rate (HR)

Acknowledging LTA Alarms

LTA alarms are latching, which means that the alarm indication will persist until both of the following conditions are met:

1. The alarm has been acknowledged by pressing the Alarm Pause (Silence)/Reset button on the front panel of the unit.

2. The alarming condition no longer exists.

Using the Heart Rate Parameter Control Panel

To configure alarms through the Heart Rate Parameter Control Panel, use the navigation keys to highlight and select the Heart Rate meter and display the HR/PR Parameter Control Panel:

Selecting the HR/PR Alarm prompt displays the HR/PR Alarm Settings menu, on which you can enable/disable Heart Rate alarms and set alarm limits.

RESP System Message

When monitoring Respiration using impedance pneumography, the Propaq M unit may display the following message:

System Message Cause

RESPIRATION FAULT The impedance measured through the ECG lead is

HR/PR Parameter Control Panel

too high for the unit to detect Respiration changes, but not high enough to indicate an ECG lead fault (the impedance may vary between 1800 and 2800 ohms).

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Chapter 8

Monitoring Non-Invasive Blood Pressure (NIBP)

The Propaq M NIBP input is Type CF defibrillator proof.

This chapter describes how to use the Propaq M unit’s NIBP option to perform Non-Invasive Blood Pressure (NIBP) measurements using an inflatable cuff to measure arterial pressure.

The Propaq M uses the enhanced NIBP features of Welch Allyn’s SureBP and patented Smartcuf motion-tolerant technology.

The Propaq M unit must perform ECG monitoring when using Smartcuf.

The SureBP monitoring software allows the Propaq M unit to take an NIBP measurement as the cuff is inflating, which saves time -- the measurement takes about 15 seconds -- and improves patient comfort.

The Smartcuf monitoring software enables the Propaq M unit to make accurate NIBP measurements in the presence of extreme artifact, weak pulses, and some dysrhythmias by synchronizing the NIBP measurements with the patient’s R-wave.

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Chapter 8 Monitoring Non-Invasive Blood Pressure (NIBP)

War ning! • Observe the patient’s limb periodically to ensure that circulation is not impaired for a

prolonged period of time.

• Do not place cuff over a wound, as this can cause further injury.

• Do not allow the NIBP tubing to become kinked or crushed. This could prevent normal

cuff deflation resulting in patient injury due to prolonged restriction of blood flow.

• Never use the Propaq M to monitor NIBP on one patient while simultaneously monitoring ECG on another patient.

• If a non-invasive blood pressure measurement is suspect, repeat the measurement. If you are still uncertain about the measurement, use another method.

• Do not use NIBP without proper training.

• Check that the correct patient mode has been selected to ensure that the initial inflation

pressure is set correctly. If an over-range indication (+++) occurs when monitoring NIBP on a large or older child, change the patient mode selection from pediatric to adult.

• Patient movement, very low pulse volume, or vibration from outside sources can influence the accuracy of blood pressure measurements.

• Do not attempt to take NIBP measurements on patients during cardiopulmonary bypass procedures.

• Some or all NIBP safety functions are disabled when performing the NIBP test in the Service menu. Do not conduct NIBP tests when the cuff is attached to a patient.

• The effectiveness of this sphygmomanometer has not been established in pregnant, including pre-eclamptic, patients.

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How does NIBP Work?

The blood pressure cuff and hose connect to the Propaq M unit through the NIBP connector on the side panel of the unit. The NIBP button on the front panel of the unit allows you to initiate and terminate blood pressure measurements, which are displayed in the NIBP area of the monitor.

The Propaq M unit’s NIBP module measures the oscillometric pulses transmitted through the blood pressure cuff and hose, and calculates the blood pressure measurements accordingly. The pressure measurement proceeds as follows:

1. The cuff inflates to a preconfigured pressure (determined by patient type) above the patient’s systolic blood pressure. As the cuff inflates, the Propaq M unit measures the oscillometric pulses transmitted from the cuff through the hose, and the SureBP monitoring software calculates the patient’s systolic, diastolic, and mean blood pressure. Once these measurements are taken, the cuff deflates. The Propaq M unit takes these measurements in about 15 seconds.

The SureBP feature requires the use of a cuff and dual lumen hose.

2. If high artifact prevents an accurate measurement during cuff inflation, or if you use a cuff

and single lumen hose, the cuff inflates to its target pressure to occlude blood flow through the arteries in the monitored limb. The cuff deflates incrementally, allowing blood to flow through the cuff and into the monitored limb. As blood flows through the partially deflated cuff, it produces pressure oscillations that are transmitted to the Propaq M unit through the hose.The Propaq M unit measures the oscillometric pulses and uses them to calculate the corresponding systolic, diastolic, and mean blood pressure. This measurement takes about 30 seconds.

3. The NIBP option automatically adjusts the blood pressure measurement procedure in

response to certain error conditions such as:

How does NIBP Work?

Condition Adjustment/Response

The unit cannot detect systolic pressure

The unit cannot detect systolic, diastolic or mean pressure after 180 seconds

The unit detects a fault The unit displays a corresponding error message on

The unit automatically increases the cuff inflation pressure and completes the blood pressure measurement

The unit aborts the blood pressure measurement and deflates the cuff

the monitor and aborts the measurement

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Chapter 8 Monitoring Non-Invasive Blood Pressure (NIBP)

138

(112)

NIBP mmHg

Artifact Symbol

The NIBP Numeric Display

When NIBP monitoring has been set up and the Propaq M unit has begun taking NIBP measurements, the systolic, diastolic, and mean blood pressure measurements appear on the NIBP numeric display as follows:

The Artifact symbol ( ) appears on the NIBP numeric display whenever the Propaq M unit detects that NIBP measurements (systolic, diastolic, mean) may be inaccurate. The symbol displays when NIBP measurements are below the specified measurement range for the selected patient type or when the accuracy of NIBP measurements may be compromised by the presence of motion artifact, weak pulses, cardiac arrhythmias or other blood pressure artifacts.

NIBP Setup and Use

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Note: For a list of system messages that may display on the Propaq M unit when monitoring

NIBP see “NIBP System Messages” on page 8-16.

The following sections describe how to set up NIBP monitoring.

To take safe and accurate NIBP measurements using the Propaq M unit, you must perform the following steps, each of which corresponds to a section in this chapter. Read each section carefully before you perform NIBP measurements.

1. Select the correct size cuff.

2. Apply the cuff to the patient.

3. Connect the inflation hose to the Propaq M unit and to the cuff.

4. Configure NIBP alarms and settings (if the current NIBP alarms and settings are not

appropriate).

5. Press the NIBP button on the Propaq M unit’s front panel and take the blood pressure

measurement.

Selecting the NIBP Cuff

To take accurate measurements, you must use the proper sized cuff: the cuff’s bladder length should be at least 80 percent of the limb circumference, while the cuff width should be equal to 40 percent of the limb circumference.

Caution Use only hoses and cuffs that are approved by ZOLL Medical Corporation. See Appendix B,

Accessories, for a listing of the approved hoses and cuffs. Use the following guidelines when selecting the appropriate hose and cuff:

Adult Mode Pediatric Mode Neonate Mode

Cuffs (typical cuff

labeling)

Recommended Limb Circumference

Hoses Adult Adult Neonate/Infant

Adult, Large Adult, Small Adult, Child, Thigh

15 cm or greater. 7.7 to 25 cm 15 cm or less

Child, Small Child, Small Adult, Infant, Newborn

Neonate #1 to #5

-- disposable

Newborn (#6), Infant (#7) -- reusable

(Disposable Cuff only)

* Reusable Newborn (#6) and Infant (#7) cuffs use the Adult Hose.

Caution Selection of the correct cuff is critical to the accuracy of NIBP measurements. Using a cuff that

is too small results in measurements higher than the patient’s actual blood pressure. Using a cuff that is too large results in measurements lower than the patient’s actual blood pressure.

The Propaq M unit uses the same definitions of Neonates, Pediatrics, and Adults as defined in the AAMI SP10:2002 standard:

Neonate or Newborn Children 28 days or less of age if born at term (37 weeks

gestation or more); otherwise, up to 44 gestational weeks

Pediatric or Child

(other than newborn)

Adult Individuals greater than 12 years of age

Individuals between 29 days and 12 years of age

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Chapter 8 Monitoring Non-Invasive Blood Pressure (NIBP)

Connecting the NIBP Cuff

Connecting the NIBP cuff requires you to attach the inflation hose to the Propaq M unit and the NIBP cuff. To use the SureBP feature, which enables the Propaq M unit to measure blood pressure on cuff inflation, you must use the FlexiPort cuff and dual lumen (two-tube) adaptor and hose. You can also use a single lumen (one-tube) hose and adaptor with the Propaq M unit, but the unit will only measure blood pressure on cuff deflation.

To connect the NIBP cuff to the Propaq M unit:

1. Attach the inflation hose’s threaded metal connector to the NIBP connector on the side panel of the Propaq M unit. Mesh the threads carefully so that the connector turns easily and then turn the connector in a clockwise direction until it is snug. Attach a double lumen hose as follows:

Attaching a Dual Lumen Hose to the Propaq M Unit

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Attach a single lumen hose as follows:

Connecting the NIBP Cuff

Attaching Single Lumen Hose to the Propaq M Unit

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Chapter 8 Monitoring Non-Invasive Blood Pressure (NIBP)

2. Insert the plastic connectors on the NIBP hose into the cuff hose connector, and twist the

connectors until they lock. The connectors are the same; you can insert either of the plastic connectors into either of the cuff hose connectors in any order.

Applying the Cuff to the Patient

To apply the cuff to the patient:

1. Ensure the patient is lying down or comfortably seated with legs uncrossed, both feet on the floor, and back supported. The limb to be used for NIBP measurement should be relaxed, extended, and placed on a smooth surface for support. The operator position is not restricted during NIBP measurement.

2. Squeeze as much air from the cuff as possible before placing it on the patient.

3. Place the cuff 2 to 5 cm above the elbow crease or 5 to 10 cm (1.9 to 3.9 in.) above the knee

crease.

War ning! • Do not place the NIBP cuff on the same arm or leg as an SpO2 sensor. Inflation of the cuff

causes the SpO

• Do not attach the cuff to a limb being used for IV infusion. Cuff inflation might block the infusion, causing harm to the patient.

• Do not place cuff over a wound, as this can cause further injury.

4. Adjust the cuff so that the artery marker on the cuff is over the artery, pointing to the hand or

foot.

monitor to read incorrectly.

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Applying the Cuff to the Patient

5. Check that the cuff ends between the range lines marked on the cuff.

6. If they do not line up, use a different size cuff.

7. Wrap the deflated cuff snugly around the limb without impeding blood flow.

8. Ensure that the hose is routed to avoid kinking or compression.

Caution • Using a cuff that is loosely applied or too small results in measurements higher than the

patient’s actual blood pressure.

• Using a cuff that is too large results in values lower than the patient’s actual blood pressure.

• Ideally, the cuff should be at the same level as the heart. Cuff placement substantially above or below heart level will result in blood pressure measurements that are erroneously low or high.

The following illustrates one possible cuff placement for adult/pediatric patients and, to the right, possible cuff placements for neonates:

Applying Cuff to the Patient

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Chapter 8 Monitoring Non-Invasive Blood Pressure (NIBP)

Ensuring Correct Cuff Inflation Settings

Before taking an NIBP measurement for a new patient, ensure that the cuff inflation settings are appropriate for that patient.

Check that the correct patient mode is selected. The initial Cuff Inflation Target (CIT) pressure is dependent on the patient type and the configured CIT preset. The default and configurable CIT presets for each patient type are indicated in the following table (default values are in bold).

Note: You can configure the CIT pressure from the Setup>NIBP menu.

Adult Pediatric Neonate

120 mmHg 80 mmHg 60 mmHg

140 mmHg 90 mmHg 70 mmHg

160 mmHg 100 mmHg 80 mmHg

180 mmHg 110 mmHg 90 mmHg

200 mmHg 120 mmHg 100 mmHg

220 mmHg 130 mmHg 110 mmHg

240 mmHg 140 mmHg 120 mmHg

260 mmHg 150 mmHg 130 mmHg

In order to accurately measure systolic pressure, the CIT pressure must be high enough to occlude the underlying artery. However, setting the CIT pressure too high may unnecessarily increase the reading determination time and patient discomfort.

After each NIBP measurement, the Propaq M unit adjusts the cuff inflation pressure to optimize the next NIBP measurement.

Note: The maximum cuff inflation pressure for neonates is 153 mmHg.

Warning! Before using the Propaq M unit to monitor a new patient, power down the unit for at

least 2 minutes to reset all patient parameters and eliminate all adjustments made for the previous patient.

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Configuring NIBP Alarms and Settings

Limits

Configuring NIBP Alarms and Settings

The last step in preparing to perform NIBP measurements is to ensure that the necessary alarms are enabled (or disabled), that alarm limits are appropriate, and that the NIBP settings are correct.

Enabling/Disabling NIBP Alarms and Setting Alarm Limits

When enabled, the Propaq M unit sounds alarms whenever measurements are outside set limits for the following:

• High and Low Systolic Pressure

• High and Low Diastolic Pressure

• High and Low Mean Arterial Pressure (MAP)

To enable (or disable) NIBP alarms and set upper and lower alarm limits, you can do so through

the Alarms quick access key ( ) or the NIBP Parameter Control Panel.

To configure NIBP alarm limits through the Alarms quick access key:

1. Press the More quick access key ( ).

2. Press the Alarms quick access key ( ).

3. Press the Limits quick access key ( ).

4. Use the navigation keys to highlight and select the appropriate alarm menu selection. For

NIBP, the alarm menu selections are NIBP Systolic Alarm, NIBP Diastolic Alarm, and NIBP MAP Alarm.

5. On the selected NIBP alarm settings menu, use the navigation keys to select the fields that

you want to change. The fields are

• Upper Limit Enable

• Lower Limit Enable

• Upper Limit

• Lower Limit

6. When you are finished changing values on the alarm settings menu, select the back arrow to

exit the menu.

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Chapter 8 Monitoring Non-Invasive Blood Pressure (NIBP)

Setting Upper and Lower Systolic Alarm Limits

Initially, the NIBP Systolic Alarm Settings menu specifies that the NIBP systolic pressure alarms are enabled ( limits. The upper and lower limits can be

ON) or disabled (OFF), and displays the default upper and lower systolic

ON or OFF (default is OFF). The following table lists

the default NIBP Systolic limits for adult, pediatric, and neonate patients, and gives the range in which you can set these limits:

Patient Type NIBP Systolic Limit Default NIBP Systolic Limit Range

Adult Lower: 75 mmHg

Upper: 220 mmHg

Pediatric Lower: 75 mmHg

Upper: 145 mmHg

Neonate Lower: 50 mmHg

Upper: 100 mmHg

Lower: 30-258 mmHg

Upper: 32-260 mmHg

Lower: 30-158 mmHg

Upper: 32-160 mmHg

Lower: 20-118 mmHg

Upper: 22-120 mmHg

Setting Upper and Lower Diastolic Alarm Limits

Initially, the NIBP Diastolic Alarm Settings menu specifies that the NIBP diastolic pressure alarms are enabled ( limits. The upper and lower limits can be

ON) or disabled (OFF), and displays the default Upper and Lower diastolic

ON or OFF (default is OFF). The following table lists

the default diastolic limits for adult, pediatric, and neonate patients, and gives the range in which you can set these limits:

Patient Type Diastolic Limit Default Diastolic Limit Range

Adult Lower: 35 mmHg

Upper: 110 mmHg

Pediatric Lower: 35 mmHg

Upper: 100 mmHg

Lower: 20-218 mmHg

Upper: 22-220 mmHg

Lower: 20-128 mmHg

Upper: 22-130 mmHg

Neonate Lower: 30 mmHg

Upper: 70 mmHg

Lower: 10-108 mmHg

Upper: 12-110 mmHg

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Zoll Propaq M User manual

Specifications and Main Features

Frequently Asked Questions

User Manual

Product Description

General Information

Propaq M Optional Features

How to Use This Manual

Operator’s Guide Updates

Unpacking

Symbols Used on the Equipment

Conventions

Propaq M Indications for Use

ECG Monitoring

Non-Invasive Blood Pressure Monitoring

Temperature Monitoring

SpO2 Monitoring

Respiration Monitoring

CO2 Monitoring

Invasive Pressure Monitoring

12-Lead Analysis

Propaq M Product Functions

ECG Monitoring

Batteries

Ready For Use (RFU) Indicator

Warnings

General

ECG Monitoring

Pulse Oximeter

Noninvasive Blood Pressure

Respiration

Ferromagnetic Equipment

Battery

Operator Safety

Patient Safety

Cautions

Restarting the Monitor

Notification of Adverse Events

Software License

Service

The ZOLL Serial Number

Product Overview

Propaq M Controls and Indicators

Propaq M with Printer (Optional) Control and Indicators

The Front Panel

Display Screen

Battery Status and Auxiliary Power Indicators

Patient Cables and Connectors

Auxiliary Power Adapter

Navigating the Display Screen

Quick Access Keys

Navigation Keys

Display Brightness Modes

Common Tasks

Setting the Date and Time

Changing the Display Brightness

Replacing a Battery Pack on the Propaq M Unit (No Printer)

Replacing a Battery Pack on the Propaq M Unit with Printer

Using Treatment Buttons

Monitoring Overview

Propaq M Monitoring Functions

Heart Rate

Respiration Rate

Temperature

Invasive Pressures (IBP)

Non-Invasive Blood Pressure (NIBP)

Capnography (CO2)

Pulse Oximetry (SpO2)

Monitoring Display Options

Configuring the Waveform Display

Trends

Displaying the Trends Status Window

Printing Trend Information

Printing Trend Summary

Printing an Individual Trend Snapshot

Printing The 10 Most Recent Trend Snapshots

Printing Specific Trend Snapshots

Changing the Trends Status Window Display

Continuous Waveform Recording

Alarms